title: Postpartum hemorrhage: a continuing challenge.
abstract: Obstetric hemorrhage remains a leading cause of maternal morbidity and mortality worldwide. Many postpartum hemorrhages (PPHs) do not have identifiable risk factors; maternity units should therefore have obstetric hemorrhageprotocols in place for all parturients as every pregnancy has the potential to be complicated by hemorrhage. This review will examine the epidemiology of PPH as well as current recommendations for key elements in obstetric hemorrhage protocols. Recent advances in hematologic management of PPH will be also be reviewed, including: (1) recognition of hypofibrinogenemia as a risk factor for severe PPH, (2) use of antifibrinolytic therapy, and (3) strategies for fibrinogen replacement therapy.
authors.affiliation: University of New Mexico Health Science Center, Departments of Pathology and Obstetrics & Gynecology, Albuquerque, NM.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Lockhart
mesh_terms: D000347:Afibrinogenemia / Q000150:complications* / Q000175:diagnosis*; D001777:Blood Coagulation; D001803:Blood Transfusion / Q000379:methods; D002986:Clinical Trials as Topic; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use; D006405:Hematology / Q000379:methods; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D009774:Obstetrics / Q000379:methods; D006473:Postpartum Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D006490:Hemostatics; D005340:Fibrinogen