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Post-partum Hemorrhage and Component Therapy

Originally posted on October 11, 2011.

Hi George! As always, I enjoy this educational resource very much! My question is: Why do healthy women who experience post-partum hemorrhage (PPH) seem to “autocorrect” their coagulopathy with very little help from component therapy? I have noted that once the bleeding site has been tended to, the patient requires relatively little support with factor/fibrinogen replacement, with respect to the hemorrhagic loss. Thanks for your input!
Crystal Azevedo, Affiliated Laboratory, Inc.

Hi, Crystal, and thank you for your question. I don’t have a ready answer, so I post this for our expert participants to field. Meanwhile, I’ll direct you to Callaghan WM, Kuklina EV, Berg CJ: Trends in postpartum hemorrhage: United States, 1994-2006. Am J Obstet Gyn 2008;202:353 for a recent PPH review with an overview of pathophysiology. The article may lead you to others that can more fully answer your question. Geo.

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