Management of blood products in the event of postpartum hemorrhage

: Transfusion during the treatment of postpartum hemorrhages is rare. It always occurs in complex situations: failure of the initial manipulations or cataclysmic bleeding. Its management is multidisciplinary and should aim at obtaining blood products within thirty minutes while preventing any risk of alloimmunization detrimental to the obstetrical future of the patient. Upstream process management is essential. The following points will be described: Within the legal bounds, the different options for blood products supply; the best practices procedures that every maternity hospital should set up and formalize; the immunohematologic documents to be used for transfusions, their validity and the criteria for the prescription of irregular antibody testing; the rules for antenatal management to anticipate the transfusion difficulties; the blood products available and their constraints of use to optimize the prescription. Effective management can be achieved only through the strict respect of procedures at every stage. These procedures should be written in conjunction with all actors, issued and regularly assessed.