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.