A woman with massive PPH has received 4 units of packed red cells. Laboratory shows INR 2.5, fibrinogen 90 mg/dL, and platelets 40,000/cmm. Which blood component is the MOST appropriate next transfusion?

• A Fresh frozen plasma
• B Packed red blood cells
• C Platelet concentrate
• D Cryoprecipitate ✓

Explanation

Fibrinogen below 100 mg/dL in PPH indicates significant hypofibrinogenemia requiring cryoprecipitate (rich in fibrinogen, factor VIII, and von Willebrand factor). FFP corrects INR but does not raise fibrinogen efficiently. Platelets are needed below 50,000 but fibrinogen replacement takes priority in active bleeding with levels this low.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.