Weiniger CF, et al. - Given that, obstetric massive transfusion protocols (MTP) suggest fixed 1:1 blood product ratios, a comparison of transfusion practice before and after protocol introduction was carried out. Researchers focused on the administration of packed red blood cells (PRBC) and fresh frozen plasma (FFP) to women with postpartum hemorrhage (PPH) before and after introduction of a massive transfusion protocol. They observed that the number and ratio of PRBC and FFP units transfused was impacted by factors other than the existence of a massive transfusion protocol among women with PPH receiving ≥3 PRBC units within a short period of time. Findings revealed that, even guidance by protocol did not result in transfusion of blood products according to exact ratios.