;WD,W

There are no firm criteria for initiating red cell transfusion. The decision to provide blood transfusion should be based on both clinical and haematological assessment.

The 2009–12 Confidential Enquiries into Maternal Deaths and Morbidity report3 highlighted the importance
of correlating clinical signs and symptoms expected from different blood loss values to help target decisions on resuscitation, and also emphasised the importance of taking the woman’s weight into account.

The therapeutic target in case of massive blood loss is to maintain Haemoglobin  greater than 8 gm/dL.

According to the RCOG Guideline- until blood is available, infuse up to 3.5 l of warmed clear fluids, initially 2 l of warmed isotonic crystalloid.

• Further fluid resuscitation can continue with additional isotonic
  crystalloid or colloid (succinylated gelatin).
• Hydroxyethyl starch should not be used.
•  The best equipment available should be used to achieve rapid warmed infusion of fluids

Cryoprecipitate should be used for fibrinogen replacement.

Fibrinogen loss can be replaced by cryoprecipitate or fibrinogen concentrate .

But fibrinogen concentrate is not licensed for acquired hypofibrinogenaemia in the UK.

According to Guidance from the British Committee
for Standards in Haematology, it is greater than 2 gram/dL

Aspirin is not recommended for thromboprophylaxis in obstetric patients.

The diagnostic criteria of DKA are-

bocarb

glucose