How I treat postpartum hemorrhage

Abstract

Worldwide, ∼800 women die every day from preventable causes related to pregnancy or childbirth. The single most common cause is severe bleeding, which can kill a healthy woman within hours if care is substandard or delayed. Improved antenatal practices have led to the early identification of at-risk women and modern technology and new techniques have enabled effective management strategies so that now, in the western world, most of the morbidity and mortality arises from those cases which occur unexpectedly and could not have been predicted. Prompt and effective management and multidisciplinary involvement is paramount to save the lives of these women. We use a case report to illustrate and discuss the main elements of management of this condition.

Prospective study of various methods used in the management of post partum haemorrhage

“…Obstetricians should choose from the available intervention, what best for the individual patient. 3 In present study PPH was most commonly seen in age group of 21-30 years which is consistence with the study done by Singh et al 5 While study done by Bouwmeester et al reported most common age group of more than 30 years. 6 The possible reason for this may be due to younger age of marriage in our country which increased gravidity and parity at younger age.…”

“…3 Hence, present study was performed to study various management methods used for the patients with PPH.…”

Massive transfusion

“…It has also been used to treat postpartum hemorrhage [42][43][44][45][46][47][48][49][50][51]. Although few prospective data exist, these situations are commonly associated with massive transfusion and the risk for rapid development of coagulopathy.…”

The Burden of Major Obstetric Hemorrhage in Near Miss in a Tertiary Care Centre in Kerala

“…major obstetric hemorrhage includes massive bleeding that occurs in a pregnant patient or immediately after delivery due to abortion,ectopic pregnancy,antepartum hemorrhage ,rupture uterus ,postpartum hemorrhage and hemorrhage due to rare causes like inversion .Major obstetric hemorrhage is defined differently in studies conducted across the world. Pavord 4 et alhas defined major obstetric hemorrhage as bleeding still ongoing after 1000ml of blood loss with loss of hemodynamic control.Study from Scotland by V Brace 5 has classified major obstetric hemorrhage as blood loss of 2500ml or more, requiring five or more units of blood transfusion This agrees to saving mother's lives 2003-05 (CEMACH) 6 which defines major obstetric hemorrhage as estimated blood loss more than 2500 ml or transfused five or more units of blood or received treatment for coagulopathy (FFP, Cryoprecipitate, platelets) 10 . WHO 3 near-miss approach in 2009 has also included massive transfusion of five units or more as severe maternal outcome.…”