Please select the eligibility criteria that correspond to the clinical trial below.
Title: Can a Single-unit Blood Transfusion Protocol in Obstetrics Reduce Total Number of Units Transfused? A Randomized, Controlled Trial
Brief Summary: There is a paucity of data on management of non-acute postpartum anemia. Although blood transfusions were historically initiated with 2 units, the most recent recommendation from the American Association of Blood Banks is to begin with 1 unit. As no randomized controlled trials have been performed in obstetrics, the investigators propose a randomized, controlled trial in non-acute postpartum anemia comparing single- versus multiple-unit transfusion by total numbers of units transfused and maternal morbidity.


Options:
A: Inclusion Criteria:

* Patients are aged 16-70 undergoing either an autologous or allogeneic HSCT for any hematologic malignancy

Exclusion Criteria:

* Pregnant or lactating at the time of enrollment
* Already received red cell transfusion after HSCT but prior to enrollment
* Unable/unwilling to provide informed consent.
* Patients receiving HSCT for non-malignancy
B: Inclusion Criteria:

* Women older than 18 years
* 12-24 hours after delivery (vaginal or caesarean section)
* Patients are in a clinical obstetric setting
* Blood loss of more than 1000 mL or Hb decrease ≥ 1,9 g/dL
* Hb value between 4.8 g/dL and 7.9 g/dL
* Working knowledge of the national language
* Written consent for participating this study (informed consent)

Exclusion Criteria:

* Patients with severe preeclampsia/ HELLP syndrome
* RBC transfusion during or after delivery but before t=0
* Patients with malignancy
* Patients with severe congenital haemolytic disease, like thalassemia or sickle cell disease
* Patients with compromised immunological status, congenital or acquired by medical treatment or infectious disease (eg. HIV)
* Severe active infectious disease at the time of proposed inclusion
* Severe cardiac, pulmonary, neurological, metabolic or psychiatric co- morbidity (ASA II/III) at the time of proposed inclusion
* Severe physical complaints (tachycardia of more than 100 bpm, dyspnoea, syncope, heart problems) at the time of intended inclusion
* Peripartum death of the newborn, or the newborn being in critical condition on neonatal intensive care
C: Inclusion Criteria:

* Women over 18
* Willing and stable to give consent
* \> 6 hours postpartum from any mode of delivery
* Determined by their physician to require blood transfusion either by:

  * Hb \<7g/dL OR
  * \>7g/dL with any sign or symptom of anemia such as fatigue, dizziness, tachycardia, or hypotension
* Agreed to accept blood transfusion
* No contraindications to blood transfusion

Exclusion Criteria:

* hemoglobinopathies
* patients with an ejection fraction \<35%
* Hb \<5 g/dL
* HR \> 130 bpm, BP \< 80/40
D: Inclusion Criteria:

* All elective primary and redo adult cardiac surgical patients for coronary artery bypass grafting, valve procedure or combined procedures
* Adults patients
* Written informed consent

Exclusion Criteria:

* Age less than 18 years
* Transplant procedures
* Emergency procedures
* Aortic repairs
* Congenital procedures
* Previous anemia (hemoglobin lower than 10 g/dL)
* Previous thrombocytopenia (platelet number lower than 100.000/mm3)
* Previous known coagulopathy
* Pregnancy
* Those unable to receive blood transfusion
* Patients who refused participation in the study

Answer: C