Secondary post-partum haemorrhage: challenges in evidence-based causes and management

Babarinsa, Isaac; Hayman, Richard

doi:10.1016/j.ejogrb.2011.07.029

Cited by 20 publications

(22 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Today thrust is being placed on evidence based management of secondary PPH and studies need to be done on traditional management approach of secondary PPH as has been highlighted by many studies. 16 Amount of bleeding varied with each patient. Mean hemoglobin level was 8.7±1.9g.Blood transfusion was given in about one third of our patients.…”

Section: Discussionmentioning

confidence: 99%

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Nigeen

Farooq

Afzal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Postpartum haemorrhage (PPH) is a very common complication that follows delivery. It is one of the leading causes of maternal mortality both in developing and developed countries. Primary PPH has been studied a lot, but data regarding secondary PPH is sparse. Our objective was to study the clinical characteristics and outcome of patients presenting with secondary PPHMethods: A retrospective descriptive study done at Lalla Ded hospital Srinagar, a tertiary care hospital of North India, between June 2015 and December 2015.Results: Fifty patients with secondary PPH were studied out of whom 36 were delivered outside this hospital and referred. Fourteen patients who delivered in this hospital developed secondary PPH. Mean age of patients was 35±3 years. Retained products of contraception (RPOCs) was the leading cause in 36 (72%) of patients followed by endometritis in ten (20%). Mean hemoglobin concentration was 8.7±1.9grams ranging from 4.4 grams to 12.9 grams. Mean hospital stay was 6.3±1.5 days ranging from 1 day to 20 days. Curettage was done in 40 (80%) of patients including 36 having RPOC s and check curettage in four patients. Fourteen (28%) patients required blood transfusion. One patient required hysterectomy. None of the patients died.Conclusions: Secondary PPH has been studied very little. Our results show retained products of contraception as a leading cause of secondary PPH which is probably related to poor management of third stage of labour. There is crucial role of active management of third stage of labour in preventing secondary PPH. Majority of secondary PPH patients require dilatation and curettage with other supportive measures only. Surgical intervention is rarely required. Blood loss is usually mild to moderate. Prognosis is good if medical intervention is sought early.

show abstract

Section: Discussionmentioning

confidence: 99%

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Nigeen

Farooq

Afzal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…Causes of secondary postpartum haemorrhage include retained placental tissue and infection. Women with low factor levels and von Willebrand disease have a significantly higher risk of both primary and secondary postpartum haemorrhage …”

Section: Postpartum Haemorrhagementioning

confidence: 99%

“…Women with low factor levels and von Willebrand disease have a significantly higher risk of both primary and secondary postpartum haemorrhage. 1,2,6, [17][18][19][20]24,43,44 The risk of postpartum haemorrhage can be reduced by the active management of the third stage of labour. 45 This includes administration of a prophylactic oxytocic agent within 2 minutes of the baby's birth to induce uterine contraction, immediate clamping and cutting of the cord to enhance placental separation, and placental delivery by controlled cord traction.…”

Section: Postpartum Haemorrhagementioning

confidence: 99%

Updated Australian consensus statement on management of inherited bleeding disorders in pregnancy

Dunkley

Curtin

Marren

et al. 2019

Medical Journal of Australia

View full text Add to dashboard Cite

IntroductionThere have been significant advances in the understanding of the management of inherited bleeding disorders in pregnancy since the last Australian Haemophilia Centre Directors’ Organisation (AHCDO) consensus statement was published in 2009. This updated consensus statement provides practical information for clinicians managing pregnant women who have, or carry a gene for, inherited bleeding disorders, and their potentially affected infants. It represents the consensus opinion of all AHCDO members; where evidence was lacking, recommendations have been based on clinical experience and consensus opinion.Main recommendationsDuring pregnancy and delivery, women with inherited bleeding disorders may be exposed to haemostatic challenges. Women with inherited bleeding disorders, and their potentially affected infants, need specialised care during pregnancy, delivery, and postpartum, and should be managed by a multidisciplinary team that includes at a minimum an obstetrician, anaesthetist, paediatrician or neonatologist, and haematologist. Recommendations on management of pregnancy, labour, delivery, obstetric anaesthesia and postpartum care, including reducing and treating postpartum haemorrhage, are included. The management of infants known to have or be at risk of an inherited bleeding disorder is also covered.Changes in management as a result of this statementKey changes in this update include the addition of a summary of the expected physiological changes in coagulation factors and phenotypic severity of bleeding disorders in pregnancy; a flow chart for the recommended clinical management during pregnancy and delivery; guidance for the use of regional anaesthetic; and prophylactic treatment recommendations including concomitant tranexamic acid.

show abstract

“…The historical cohort studies are often old or raise questions about the quality of the pathology examinations performed . No published European cohort study has assessed the frequency or causes of secondary PPH, and no scientific evidence supports any of the current treatment options . It is thus understandable that there are no guidelines for its management in France.…”

mentioning

confidence: 99%

“…In practice, clinicians lack adequate knowledge of the different causes of secondary PPH and focus mainly on the presence or absence of placental retention on ultrasound, without considering other possible causes . Fung et al have reported, however, that retained tissue was histologically confirmed in less than half of the women who underwent uterine evacuation for retained placental tissue .…”

mentioning

confidence: 99%

Severe Secondary Postpartum Hemorrhage: A Historical Cohort

Dossou

Debost‐Legrand

Déchelotte³

et al. 2015

Birth

View full text Add to dashboard Cite

show abstract

Secondary post-partum haemorrhage: challenges in evidence-based causes and management

Cited by 20 publications

References 35 publications

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Updated Australian consensus statement on management of inherited bleeding disorders in pregnancy

Severe Secondary Postpartum Hemorrhage: A Historical Cohort

Contact Info

Product

Resources

About