Latest advances in postpartum hemorrhage management

Kumaraswami, Sangeeta; Butwick, Alexander J.

doi:10.1016/j.bpa.2022.02.004

Cited by 14 publications

(14 citation statements)

References 93 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…31 Adoption of hemorrhage bundles may increase clinical awareness of postpartum hemorrhage, leading to increased clinical diagnosis of postpartum hemorrhage and more timely medical management with new adjunctive therapies decreasing the need for more invasive downstream interventions. [32][33][34] Our finding that peripartum hysterectomy rates among hospitalized individuals with postpartum hemorrhage are stable to decreasing is contrary to a recently published observational study using birth certificate data, which found increasing unplanned peripartum hysterectomy rates from 2009 to 2020, thought to be secondary to placenta accreta spectrum. 35 This discrepancy may be due to a combination of factors, including limitations of billing and natality data, differential indications for peripartum hysterectomy, and study modeling.…”

Section: Discussioncontrasting

confidence: 86%

Postpartum Hemorrhage Trends and Outcomes in the United States, 2000–2019

Corbetta-Rastelli

Friedman

Sobhani

et al. 2022

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

To analyze temporal trends in and risk factors for postpartum hemorrhage and to analyze the association of risk factors with postpartum hemorrhagerelated interventions such as blood transfusion and peripartum hysterectomy.METHODS: This repeated cross-sectional study analyzed delivery hospitalizations from 2000 to 2019 in the National (Nationwide) Inpatient Sample. Trends analyses were conducted using joinpoint regression to estimate the average annual percent change (AAPC) with 95% CIs. Unadjusted and adjusted survey-weighted logistic regression models were performed to evaluate the relationship between postpartum hemorrhage risk factors and likelihood of 1) postpartum hemorrhage, 2) postpartum hemorrhage that requires blood transfusion, and 3) peripartum hysterectomy in the setting of postpartum hemorrhage, with unadjusted odds ratios and adjusted odds ratios with 95% CIs as measures of association. RESULTS:Of an estimated 76.7 million delivery hospitalizations, 2.3 million (3.0%) were complicated by postpartum hemorrhage. From 2000 to 2019, the rate of

show abstract

Section: Discussioncontrasting

confidence: 86%

Postpartum Hemorrhage Trends and Outcomes in the United States, 2000–2019

Corbetta-Rastelli

Friedman

Sobhani

et al. 2022

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…Quantification of blood loss using combination of gravimetric techniques, volumetric drapes, and colorimetry is more accurate than visual assessment which might underestimate the loss. [ 41 ] The World Health Organization (WHO) has added IV tranexamic acid 1 gm in ‘first response care’ for haemorrhage following the World Maternal Antifibrinolytic (WOMAN) trial. [ 41 , 42 ] However, reports from Tranexamic Acid for Preventing Postpartum Hemorrhage (TRAAP) 1 and 2 trials do not entirely support this.…”

Section: Management Of Obstetric Comorbiditiesmentioning

confidence: 99%

“…[ 41 ] The World Health Organization (WHO) has added IV tranexamic acid 1 gm in ‘first response care’ for haemorrhage following the World Maternal Antifibrinolytic (WOMAN) trial. [ 41 , 42 ] However, reports from Tranexamic Acid for Preventing Postpartum Hemorrhage (TRAAP) 1 and 2 trials do not entirely support this. [ 41 ] Point-of-care test (POCT) of coagulation based on viscoelastometry including rotational thromboelastometry (ROTEM) and thromboelastography have been found very useful and been endorsed by the NICE and Royal College of Obstetricians and Gynaecologists.…”

Section: Management Of Obstetric Comorbiditiesmentioning

confidence: 99%

“…[ 41 , 42 ] However, reports from Tranexamic Acid for Preventing Postpartum Hemorrhage (TRAAP) 1 and 2 trials do not entirely support this. [ 41 ] Point-of-care test (POCT) of coagulation based on viscoelastometry including rotational thromboelastometry (ROTEM) and thromboelastography have been found very useful and been endorsed by the NICE and Royal College of Obstetricians and Gynaecologists. [ 40 ] Limitations include the cost and feasibility.…”

Section: Management Of Obstetric Comorbiditiesmentioning

confidence: 99%

See 1 more Smart Citation

Recent advances in obstetric anaesthesia and critical care

et al. 2023

View full text Add to dashboard Cite

Newer modalities in labour analgesia and anaesthesia for caesarean section including regional anaesthesia techniques and airway management are emerging constantly. Techniques such as point of care ultrasound, especially of the lungs and stomach and point of care tests of coagulation based on viscoelastometry are about to revolutionise perioperative obstetric care. This has improved the quality of care thereby ensuring good perioperative outcomes in the parturient with comorbidities. Critical care for obstetrics is an emerging field that requires a multidisciplinary approach with obstetricians, maternal-foetal medicine experts, intensivists, neonatologists, and anaesthesiologists working together with enhanced preparedness and uniform protocols. Newer techniques and concepts of understanding have thus been established in the traditional speciality of obstetric anaesthesia over the last decade. These have improved maternal safety and neonatal outcomes. This article touches upon some recent advances that have made a significant impact in the field of obstetric anaesthesia and critical care.

show abstract

“…The primary cause of PPH is uterine atony, a failure of the uterus to contract adequately after delivery. Other contributing factors include retained placental tissue, genital tract trauma, and coagulopathy 1 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Carbetocin in Prevention of Postpartum Hemorrhage

Arif¹,

Tahir²,

Aftab³

et al. 2023

PJMHS

View full text Add to dashboard Cite

Objective: The study compared the effectiveness of carbetocin and oxytocin, administered post caesarian section for prevention of postpartum haemorrhage (PPH). Study Design: This was a prospective single center, case-control, cross sectional, observational, double ended study conducted from September 2020 to January 2022, comprising 150 female patients. Methods: The study was conducted at Hameeda Memorial Hospital Lahore in women undergoing caesarean section under regional and general anesthesia. Women were randomized to receive either carbetocin or oxytocin 5 IU intravenously. Results: Average age of patients was 34.5 years with average BMI of 27. It was noted that patients who were administered drugs had 348.6ml less blood loss than those not administered in PPH. Patients who did not received the drugs had average 800 ml blood loss. Whereas those who did had the drug had average of 451ml loss of bleed in PPH. Carbetocin showed effectiveness in preventing PPH by maintaining uterine tone. It was found that it significantly reduced the need for additional uterine contractile interventions to prevent or treat excessive bleeding after cesarean. In high-risk women, carbetocin has been found to be more effective than oxytocin in preventing blood loss greater than 500 mL during the cesarean section. Practical Implication: This study will help the gynecologists in selecting potent and safe therapeutic agents for the prevention of postpartum hemorrhages in high risk females. Conclusion: Carbetocin has been shown to be a safe and effective option for the prevention of postpartum hemorrhage in high-risk women as compared to other therapeutic agents along with potential safety margins. Keywords: Carbetocin, efficacy, safety, prevention, postpartum hemorrhage, oxytocin, uterotonic

show abstract

Latest advances in postpartum hemorrhage management

Cited by 14 publications

References 93 publications

Postpartum Hemorrhage Trends and Outcomes in the United States, 2000–2019

Postpartum Hemorrhage Trends and Outcomes in the United States, 2000–2019

Recent advances in obstetric anaesthesia and critical care

Efficacy and Safety of Carbetocin in Prevention of Postpartum Hemorrhage

Contact Info

Product

Resources

About