Blood transfusion, IV fluids, and circulatory overload in women giving birth with moderate or severe anaemia

Bleeding leads to hypovolemia (low blood volume) and shock. Intravenous (IV) fluids and blood products are often given to women who bleed heavily after childbirth to replace blood volume and ultimately prevent death. Transfusion-associated-circulatory-overload (TACO) is a life-threatening pulmonary complication of blood transfusion that is mediated by fluid overload. IV fluids can lead to a similar complication. We refer to this complication as ‘circulatory overload’ from hereon. Administration of larger volumes of fluid/blood increases the risk of circulatory overload. The WOMAN-2 study showed that women with severe anaemia are more likely to show signs of haemodynamic instability, and therefore, be diagnosed and treated for postpartum haemorrhage (PPH) after moderate blood loss (