Fluid and Transfusion Strategies in Obstetric Hemorrhage: An Evidence-Based Review

Obstetric hemorrhage remains a leading cause of maternal mortality and severe morbidity worldwide. The management of fluid resuscitation and blood product transfusion in these critical situations has evolved significantly over the past decade. This review explores contemporary evidence-based approaches to volume replacement and hemostatic resuscitation in obstetric hemorrhage, with particular emphasis on recent developments in transfusion protocols, point-of-care testing, and goal-directed therapy. Recent Cochrane reviews, randomized controlled trials, and meta-analyses were evaluated to provide a comprehensive analysis of best practices. The evidence suggests a paradigm shift toward early recognition, balanced resuscitation strategies, ratio-based transfusion protocols, and individualized approaches guided by viscoelastic testing. This review critically examines these developments and provides practical recommendations for clinical implementation while acknowledging persistent knowledge gaps that require further investigation.