title: [Postpartum hemorrhage--an update].
abstract: 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. All labor and delivery suites should have standard operating procedures for the management of postpartum hemorrhage in place with regular drills.
authors.affiliation: Klinik für Anästhesiologie und operative Intensivmedizin am Klinikum Harlaching in München. wiebke.gogarten@klinikum-muenchen.de
authors.forename: Wiebke
authors.initials: W
authors.lastname: Gogarten
mesh_terms: D000328:Adult; D001688:Biological Products / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D001803:Blood Transfusion; D003906:Developing Countries; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D010121:Oxytocin / Q000627:therapeutic use; D010949:Plasma; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control / Q000601:surgery / Q000628:therapy*; D011247:Pregnancy; D018570:Risk Assessment
chemical_list: D001688:Biological Products; D001779:Blood Coagulation Factors; D010121:Oxytocin