Evidence map›Paper›PMID 41825371›Full record

ArticleInternational journal of obstetric anesthesia2026

Morbidity associated with fresh frozen plasma administration for postpartum hemorrhage requiring transfusion: a retrospective cohort study (2016-2024).

Lillian Liao, Vesela P Kovacheva, Michaela K Farber, John J Kowalczyk

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Article in International journal of obstetric anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Lillian LiaoDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: lliao3@bwh.harvard.edu.
Vesela P KovachevaDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Michaela K FarberDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
John J KowalczykDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Funding

Personalized Postpartum Hemorrhage Prediction Using Machine Learning And Polygenic Risk ScoresK08HL161326 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Vesela Kovacheva · 2022 to 2026
$842k
NHLBI NIH HHS 1K08HL161326-01A1NHLBI NIH HHS K08 HL161326
6 · The paper itself

Abstract

backgroundRecommendations for fresh frozen plasma transfusion in postpartum hemorrhage are inconsistent and empiric administration may carry more risk than benefit. We characterized fresh frozen plasma use for postpartum hemorrhage with normal international normliazed ratio (INR) and associated adverse outcomes.

methodsPatients with postpartum hemorrhage (quantitavie blood loss ≥1000 mL) and INR ≤1.5 who received transfusion of any blood product during their delivery admission in a large tertiary academic center between 2016 and 2024 were identified. Those who received fresh frozen plasma were compared to those who did not.

resultsAmong 54,041 deliveries during the study period, 3,827 (7.1%) had a diagnosis of postpartum hemorrhage of which 530 (0.98%) were transfused. Among these, 489/530 (92%) had an INR ≤1.5, yet 37% received fresh frozen plasma. First fresh frozen plasma was frequently transfused prior to INR availability (62.8%). After adjusting for significant covariates, patients transfused with fresh frozen plasma had higher odds of composite adverse outcomes, admission to intensive care unit, and prolonged length of stay.

conclusionDespite coagulopathy being uncommon during postpartum hemorrhage, fresh frozen plasma is often administered empirically in patients with normal INR and is associated with increased risk of adverse outcomes.

Indexed as

Blood Component TransfusionBlood TransfusionPlasmaPostpartum HemorrhageAdultCohort StudiesFemaleHumansInternational Normalized RatioPregnancyRetrospective StudiesCoagulopathyFresh Frozen PlasmaMaternal morbidityObstetricPostpartum hemorrhageTRALI

Identifiers

PMID41825371
PMCPMC13271832

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