{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T08:58:50Z","timestamp":1769849930399,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T00:00:00Z","timestamp":1591833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Most low\u2010risk obstetric patients do not have crossmatched blood available to treat unexpected postpartum hemorrhage. An emergency\u2010release blood transfusion (ERBT) program is critical for hospitals with obstetrical services. We performed a retrospective analysis of obstetrical ERBTs administered in our multihospital system.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN AND METHODS<\/jats:title><jats:p>We collected data from the past 8\u2009years at all Intermountain Healthcare hospitals on every ERBT after postpartum hemorrhage; logging circumstances, number and type of transfused products, and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Eighty\u2010nine women received ERBT following 224,035 live births, for an incidence of 3.97 transfused women\/10,000 births. The most common causally\u2010associated conditions were: uterine atony (40%), placental abruption\/placenta previa (16%), retained placenta (11%), and uterine rupture (5%). The mean number of total units transfused was 7.9 (range 1\u201076). The mean number of red blood cells (RBCs) transfused was 4.8, the median 4, and SD was \u00b14.4. Massive transfusion protocols (MTPs) for trauma recommend using a ratio of 1:1:1 or 2:1:1 of RBC:FFP:Platelets, however the ratios varied widely for postpartum hemorrhage. Only 1.5% received a 1:1:1 ratio and 7.5% received a 2:1:1 ratio. Nineteen percent (17\/89) of women underwent hysterectomy, 7% (6\/89) had uterine artery embolization, 36% (32\/89) had an intensive care unit admission, and 1% (1\/89) died.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Emergency transfusion for postpartum hemorrhage occurred after 1\/2500 births. Most women received less FFP and platelets than recommended for traumatic hemorrhage. A potentially better practice for postpartum hemorrhage would be a balanced ratio of blood products, transfusion of low\u2010titer, group O, cold\u2010stored, whole blood, or inclusion in a MTP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15903","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T03:13:18Z","timestamp":1591931598000},"page":"1418-1423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Emergency\u2010release blood transfusions after postpartum hemorrhage at the Intermountain Healthcare hospitals"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5228-6501","authenticated-orcid":false,"given":"Whitley","family":"Hulse","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics University of Utah Health  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7946-0290","authenticated-orcid":false,"given":"Timothy M.","family":"Bahr","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics University of Utah Health  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7036-2849","authenticated-orcid":false,"given":"David S.","family":"Morris","sequence":"additional","affiliation":[{"name":"Trauma and General Surgery Intermountain Medical Center  Murray Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas S.","family":"Richards","sequence":"additional","affiliation":[{"name":"Division of Maternal\/Fetal Medicine University of Utah Health and Intermountain Medical Center  Murray Utah USA"},{"name":"Women and Newborn's Clinical Program Intermountain Healthcare  Murray Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah J.","family":"Ilstrup","sequence":"additional","affiliation":[{"name":"Department of Pathology Intermountain Healthcare Transfusion Services and Intermountain Medical Center  Murray Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert D.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics University of Utah Health  Salt Lake City Utah USA"},{"name":"Division of Maternal\/Fetal Medicine University of Utah Health and Intermountain Medical Center  Murray Utah USA"},{"name":"Division of Hematology\u2010Oncology University of Utah Health  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000399"},{"key":"e_1_2_8_3_1","first-page":"B5444","article-title":"Aetiology and treatment of severe postpartum haemorrhage","volume":"65","author":"Edwards HM","year":"2018","journal-title":"Dan Med 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