Planning for hemorrhage. Steps an anesthesiologist can take to limit and treat hemorrhage in the obstetric patient.
Obstetric hemorrhage continues to be a significant cause of maternal mortality and morbidity. Blood transfusion in such circumstances may be life saving but involves exposing the patient to additional risks. Limiting blood transfusion and using autologous blood when possible may reduce some of these risks. This article outlines the techniques that may be used to limit and more effectively treat hemorrhage in the obstetric patient, with particular attention paid to reducing the use of allogeneic blood transfusion.
Esler
Mark D
MD
Department of Anesthesia, Division of Obstetric Anesthesia, University of British Columbia, British Columbia's Women's Hospital, Vancouver, British Columbia, Canada. mesler@cw.bc.ca
Douglas
M Joanne
MJ
D000773:Anesthesia, Obstetrical; D001778:Blood Coagulation Disorders / Q000628:therapy*; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D002585:Cesarean Section; D005260:Female; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D007744:Obstetric Labor Complications / Q000628:therapy; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy*; D012307:Risk Factors