Clinical meaning
Obstetric Hemorrhage: Massive Transfusion involves alterations in hematopoiesis, hemoglobin function, coagulation, or fibrinolysis relevant to obstetric hemorrhage.
Diagnosis & workup
Diagnostics & workup: - Hemoglobin electrophoresis for hemoglobinopathy screening - Peripheral smear morphology (schistocytes, spherocytes, target cells) - Bone marrow biopsy for unexplained cytopenias or suspected malignancy - Fibrinogen level for DIC or consumption coagulopathy - Direct antiglobulin test (Coombs) for autoimmune hemolytic anemia - B12 and folate levels (methylmalonic acid if B12 borderline) - PT/INR and aPTT for coagulation pathway assessment
Risk factors: - Splenomegaly with hypersplenism - Chemotherapy-induced myelosuppression - Recent surgery or trauma with blood loss - Family history of hereditary hematologic conditions (sickle cell, thalassemia) - Autoimmune conditions (ITP, AIHA, TTP-HUS) - Chronic kidney disease with decreased erythropoietin - Anticoagulant or antiplatelet therapy increasing bleeding risk