Outcomes for women requiring large volume blood transfusions for postpartum haemorrhage at public hospitals are similar regardless of whether or not the patient is in a tertiary centre, a study shows.

This finding is reassuring, the study authors say, as their analysis also confirms the difficulty in predicting which women are at risk of ‘massive’ postpartum haemorrhage (PPH), underlining the need for all hospitals to be able to deal with a major bleed.

Records for nearly 232,000 births between 2006 and 2010 were matched with data from the NSW Clinical Excellence Commission’s Blood Watch database and the Australian Red Cross Lifeblood database to determine the number of units of red cells transfused.

While most births did not lead to haemorrhage, 4309 (1.9%) involved PPH requiring at least one unit of red cells and 1011 births (0.4%) required four or more units, the authors reported in BMC Pregnancy and Childbirth.