Diagnosis and treatment of peripartum bleeding.
Severe peripartum hemorrhage (PPH) contributes to maternal morbidity and mortality and is one of the most frequent emergencies in obstetrics, occurring at a prevalence of 0.5-5.0%. Detection of antepartum risk factors is essential in order to implement preventive measures. Proper training of obstetric staff and publication of recommendations and guidelines can effectively reduce the frequency of PPH and its resulting morbidity and mortality. Therefore, an interdisciplinary expert committee was formed, with members from Germany, Austria, and Switzerland, to summarize recent scientific findings. An up-to-date presentation of the importance of embolization and of the diagnosis of coagulopathy in PPH is provided. Furthermore, the committee recommends changes in the management of PPH including new surgical options and the off-label use of recombinant factor VIIa.
Henrich
Wolfgang
W
Department of Obstetrics, Charité-University Medicine Berlin, 13353 Berlin, Germany. Wolfgang.Henrich@charite.de
Surbek
Daniel
D
Kainer
Franz
F
Grottke
Oliver
O
Hopp
Hartmut
H
Kiesewetter
Holger
H
Koscielny
Jürgen
J
Maul
Holger
H
Schlembach
Dietmar
D
von Tempelhoff
Georg-Friedrich
GF
Rath
Werner
W
D001317:Austria; D001803:Blood Transfusion; D015984:Causality; D003029:Coagulants / Q000627:therapeutic use; D015897:Comorbidity; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D004621:Embolization, Therapeutic; D005167:Factor VII / Q000627:therapeutic use; D005260:Female; D005858:Germany; D006801:Humans; D007044:Hysterectomy; D008755:Methylergonovine / Q000627:therapeutic use; D010120:Oxytocics / Q000627:therapeutic use; D010121:Oxytocin / Q000627:therapeutic use; D018457:Placenta, Retained / Q000453:epidemiology / Q000628:therapy; D006473:Postpartum Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology / Q000628:therapy; D011453:Prostaglandins / Q000627:therapeutic use; D012307:Risk Factors; D013536:Suture Techniques; D013557:Switzerland; D014593:Uterine Inertia / Q000453:epidemiology / Q000628:therapy; D014597:Uterine Rupture / Q000453:epidemiology / Q000628:therapy; D014599:Uterus / Q000473:pathology / Q000601:surgery
D003029:Coagulants; D010120:Oxytocics; D011453:Prostaglandins; D010121:Oxytocin; D005167:Factor VII; D008755:Methylergonovine