Blood Component Therapy and Massive Transfusion

This chapter is intended to aid in understanding the preparation of, indications for, and potential complications of blood components for obstetric critical care. The prerequisites for blood donors are stringent, and require that the potential donor be in good health and not have been exposed to drugs, which may have deleterious effects on the integrity of blood components or have deleterious effects on the recipients. Patients with bleeding diathesis are at increased risk for postpartum hemorrhage. Platelet disorders are heterogeneous diseases like von Willebrand disease with a wide spectrum of bleeding symptoms and severity. Hypothermia due to massive transfusion of unwarmed red blood cells has been associated with decreased platelet and enzyme activity and may contribute to worsening coagulopathy. Autologous blood collection falls into two major categories: preoperative donation and perioperative collection. Transfusion reactions can complicate up to 10% of all transfusions.