Postpartum Hemorrhage Resulting From Uterine Atony After Vaginal Delivery

Abstract

II.

Predictors of severity in primary postpartum hemorrhage

“…Oxytocin is commonly used to maintain uterine contractility during labor and to stop bleeding after delivery [17]. However, similar to our finding, previous studies have reported the association of labor augmentation with oxytocin and severe PPH [16]. Desensitization of the oxytocin receptor to the uterotonic effects of oxytocin has been suggested to be the underlying cause [18].…”

“…Additionally, as demonstrated in this study, atony is also the leading etiology of severe PPH. The oxytocin augmentation and prolonged labor, which are the independent predictors for severe PPH, were also known to be risk factors for uterine atony [16]. Oxytocin is commonly used to maintain uterine contractility during labor and to stop bleeding after delivery [17].…”

Predictive factors of advanced interventional procedures in a multicentre severe postpartum haemorrhage study

“…uterine artery embolization and/or haemostatic surgery, are recommended, unfortunately there is no unequivocal evidence as to when, or based on what parameters, a more invasive therapy should be initiated [13]. This lack of ''accepted'' (and easily measurable bed-side) parameters indicating the failure of conservative therapy and the need for an AIP, has undoubtedly led in many cases to delays in initiation of aggressive therapy and/or transfer to a specialized tertiary care centre, and it has been proven that delay in initial care is an independent predictor of severe blood loss in women with PPH [14].…”

Efficacité et sécurité de l’acide tranexamique en prévention et/ou en traitement de l’hémorragie du post-partum : une revue systématique de la littérature avec méta-analyse

“…Compte tenu des faibles connaissances que nous avons en termes de dose optimale et d'effets secondaires, l'administration prophylactique ne pourrait être conseillé e que chez les patientes à haut risque d'hé morragie du post-partum, tenant compte de critè res validé s dans la litté rature (ané mie pendant la grossesse, anté cé dent d'hé morragie du post-partum, anomalie de placentation) [41][42][43].…”