Transfusion of Blood and Blood Products

Dr. Recep Taha Ağaoğlu1
Assoc. Prof. Dr. Ahmet Şeyhanlı2

1Department of Perinatology, Ankara Etlik City Hospital, Ankara, Türkiye
2Department of Hematology, Gazi University Faculty of Medicine, Ankara, Türkiye

ABSTRACT

Placenta accreta spectrum (PAS) is one of the obstetric emergencies and a leading cause of maternal mor- bidity and mortality. PAS is characterized by an abnormal invasion of the placenta into the myometrium and can lead to life-threatening blood loss during delivery. Therefore, an accurate assessment of the amount of bleeding and the determination of appropriate transfusion strategies are crucial in the management of PAS. In PAS cases, blood loss during surgery is usually higher than expected, and massive blood transfusions can often occur, especially in emergency surgery. In blood transfusion management, the use of red blood cell suspensions, platelet and plasma products in appropriate proportions is crucial to ensuring hemostasis. In addition, monitoring of fibrinogen levels and replacement with fibrinogen concentrate or cryoprecipitate, if necessary, are important to control potential coagulopathy. Effective implementation of massive transfusion protocols and adjustment of the transfusion rate to the patient’s hemodynamic status will help improve mater- nal outcomes. In the treatment of PAS, correction of anemia in the preoperative phase, minimization of blood loss during surgery, and monitoring of potential complications in the postoperative phase require a multidisci- plinary approach. In this context, tailoring a treatment plan according to the individual characteristics of each patient is crucial to optimizing maternal and fetal outcomes.

Keywords: Placenta accreta spectrum; Blood component transfusion; Maternal mortality

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