title: Cutting-edge advances in the medical management of obstetrical hemorrhage.
abstract: Hemorrhagic shock is the most common form of shock encountered in obstetric practice. Interventions that may limit transfusion requirements include normovolemic hemodilution, use of recombinant activated factor VII, selective embolization of pelvic vessels by interventional radiology, and the use of the cell saver intraoperatively. Current understanding of the mechanisms of acute coagulopathy calls into question the current transfusion guidelines, leading to a tendency to apply massive transfusion protocols based on hemostatic resuscitation despite lack of prospective data.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Luis D
authors.initials: LD
authors.lastname: Pacheco
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.forename: Alfredo F
authors.initials: AF
authors.lastname: Gei
authors.forename: Gary D V
authors.initials: GD
authors.lastname: Hankins
mesh_terms: D001803:Blood Transfusion / Q000592:standards*; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000628:therapy*