Postpartum hemorrhage revisited

new challenges and solutions

Research output: Contribution to journalArticle

Abstract

PURPOSE OF REVIEW: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality in the United States, and worldwide. Recognition of PPH is challenging, but once hemorrhage is recognized, management needs to focus on achieving adequate uterine tone and maintaining maternal hemodynamic stability. There have been several advances in the management of postpartum hemorrhage, many of which can be implemented at the labor and delivery unit level. RECENT FINDINGS: There have been many advances in the understanding of at-risk parturients, and the use of hemorrhage protocols and safety bundles have been shown to improve patient outcomes. There are many new advances in transfusion management (e.g. fibrinogen concentrate, prothrombin complex concentrate, tranexamic acid) that can compliment traditional component therapy. Consideration should be given to transferring women at high risk for complications (e.g. invasive placentation) to a higher level facility for delivery. SUMMARY: Although postpartum hemorrhage itself may not be preventable, early identification of blood loss, and mobilization of resources may prevent adverse outcomes. Multidisciplinary planning at the system level, ensuring that hemorrhage protocols exist, as well as for management of high-risk patients is important for improving patient outcomes.

Original languageEnglish (US)
Pages (from-to)278-284
Number of pages7
JournalCurrent opinion in anaesthesiology
Volume32
Issue number3
DOIs
StatePublished - Jun 1 2019

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Postpartum Hemorrhage
Hemorrhage
Tranexamic Acid
Placentation
Maternal Mortality
Risk Management
Fibrinogen
Hemodynamics
Mothers
Parturition
Morbidity
Safety
Therapeutics

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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Postpartum hemorrhage revisited : new challenges and solutions. / Higgins, Nicole; Patel, Samir Kaushik; Toledo, Paloma.

In: Current opinion in anaesthesiology, Vol. 32, No. 3, 01.06.2019, p. 278-284.

Research output: Contribution to journalArticle

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