Postpartum hemorrhage - an update

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, 08/04/2011

Gogarten W –All labor and delivery suites should have standard operating procedures for the management of postpartum hemorrhage in place with regular drills.

  • Postpartum hemorrhage remains a major cause of maternal morbidity and mortality.
  • The incidence of postpartum hemorrhage appears to be increasing in developed countries due to an increased number of placenta accreta or percreta after previous Cesarean deliveries.
  • The initial therapy of postpartum hemorrhage consists of uterotonic drugs and inspection of the uterine cavum.
  • At the same time, optimization of the clotting potential should be initiated early.
  • Tranexamic acid may be considered as a first line choice, followed by fibrinogen if necessary.
  • If bleeding continues, fresh frozen plasma and packed red cells should be ordered in a ratio of 1:1, as this ratio has been shown to improve survival in trauma victims.

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