title: The impact of postpartum haemorrhage management guidelines implemented in clinical practice: a systematic review of the literature.
abstract: Postpartum haemorrhage (PPH) is an urgent obstetric condition requiring an immediate response and a multidisciplinary approach. The aim of this study was to review PPH management guidelines implemented in clinical practice, to evaluate their impact regarding prevention, diagnosis and treatment, and to analyze how the numbers of PPH cases changed in the post-intervention period. A systematic search in the PubMed database was performed. The references of all included articles were examined. Studies evaluating the management of PPH and the impact on the numbers of cases of this pathology after the implementation of new or updated guidelines were involved in the analysis. Two reviewers independently examined the titles and abstracts of all identified citations, selected potentially eligible studies, and evaluated their full-text versions. Methodological quality was assessed using a checklist based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. We analyzed seven articles that evaluated the impact of new or updated guidelines for PPH management implemented in clinical practice. In four trials, the numbers of PPH cases declined after the intervention. Guidelines for PPH management can have a positive impact on the reduction of the number of PPH cases.
authors.affiliation: Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Ruta J
authors.initials: RJ
authors.lastname: Nadisauskiene
authors.affiliation: Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Mindaugas
authors.initials: M
authors.lastname: Kliucinskas
authors.affiliation: Crisis Research Centre, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Paulius
authors.initials: P
authors.lastname: Dobozinskas
authors.affiliation: Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: jusbra@hotmail.com.
authors.forename: Justina
authors.initials: J
authors.lastname: Kacerauskiene
mesh_terms: D005260:Female; D019983:Guideline Adherence / Q000639:trends*; D006801:Humans; D007749:Labor Stage, Third; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011247:Pregnancy
keywords: Guidelines; Management; Outcomes; Postpartum haemorrhage