title: [Management of major postpartum hemorrhage].
abstract: Postpartum hemorrhage (PPH) is defined by loss of greater than 500 mL of blood following vaginal delivery or 1,000 mL of blood following cesarean section, in the first 24 hours postpartum. Its incidence is up to 5% and the severe forms represent 1% of births. PPH is the first cause of obstetrical maternal mortality in France and 90% of these deaths are considered as preventable. Its management is multidisciplinary (obstetricians, anesthetists, midwives, biologists and interventional radiologists), based on treatment protocols where time is a major prognosis factor. In case of failure of the initial measures (oxytocin, manual placenta removal, uterus and birth canal examination), the management of severe forms includes active resuscitation (intravenous fluids, blood transfusion, vasoactive drugs), haemostatic interventions (sulprostone, tamponnade and haemostatic suture, surgical procedures and arterial embolization) and the correction of any potential coagulopathy (administration of blood products and haemostatic agents).
authors.affiliation: AP-HP, CHU Louis-Mourier, service d'anesthésie, université Paris 7, 92701 Colombes cedex, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Nebout
authors.affiliation: AP-HP, CHU Louis-Mourier, service d'anesthésie, université Paris 7, 92701 Colombes cedex, France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Merbai
authors.affiliation: AP-HP, CHU Louis-Mourier, service d'anesthésie, université Paris 7, 92701 Colombes cedex, France.
authors.forename: Valentina
authors.initials: V
authors.lastname: Faitot
authors.affiliation: AP-HP, CHU Louis-Mourier, service d'anesthésie, université Paris 7, 92701 Colombes cedex, France. Electronic address: hawa.keita@lmr.aphp.fr.
authors.forename: Hawa
authors.initials: H
authors.lastname: Keita
mesh_terms: D001803:Blood Transfusion; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005440:Fluid Therapy; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D006473:Postpartum Hemorrhage / Q000188:drug therapy / Q000628:therapy*; D011247:Pregnancy; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D006490:Hemostatics; D014662:Vasoconstrictor Agents