Abstract: Objective To explore optimizing transfusion ratios of different blood products in postpartum hemorrhage requiring massive blood transfusion (MT). Methods A retrospective study was performed using data from all patients who underwent a MT in the Obstetrics Department of the Third Affiliated Hospital of Guangzhou Medical University from May 2018 to April 2021. The information including patient's general condition, cause of postpartum hemorrhage, amount of blood loss, amount of blood products and patient outcomes were collected. Results Placental factors was the main cause of postpartum hemorrhage (84.00%), of which 69.00% was caused by placenta accreta. One hundred patients with postpartum hemorrhage received a MT, and the bleeding of 84 patients were well controlled. The mean estimated blood loss was 2 778 mL. Each patient required blood transfusion at a mean of 8.6 units of packed red blood cells, 543 mL of fresh frozen plasma and 352 mL of frozen plasma. Among the five groups of patients with postpartum hemorrhage who received MT, group 1 (red blood cell∶plasma=1∶1) and group 3 (red blood cell∶plasma=6∶4) had the highest blood transfusion efficiency (96.88%, 94.12%). Conclusion A reasonable mass transfusion program is an important treatment for postpartum hemorrhage. A 1∶1 program of red blood cells and plasma is recommended, then 6∶4 program of platelets and/or cryoprecipitate should be given as early as possible.

Key words: Postpartum hemorrhage, Massive transfusion, Coagulation dysfunction