title: [The new German guideline on postpartum haemorrhage (PPH): essential aspects for coagulation and circulatory therapy].
abstract: Worldwide, post-partum haemorrhage (PHH) remains one of the leading causes for maternal mortality. The German Society of Gynaecology and Obstetrics, the German Midwifes' Society, the German Society of Thrombosis and Haemostasis and the German Society of Anaesthesiology and Intensive Care updated the former guideline. The resulting recommendations are the results of a structured literature search and a formal consensus process and contain all aspects of PPH including diagnosis, causes, risk factors and therapy. Key aspect of the anaesthesiological and haemostatic therapies is the development of an interdisciplinary standard operating procedure containing medical options related to the bleeding's cause and severity as well as the surgical option. For suspected PPH, this guideline emphasizes clinical and laboratory-based diagnostics, as only those will enable an early identification of the bleeding's causes and the resulting causative therapy. Recommendations cover evidence-based application of uterotonics for atony as well as tranexamic acid, calcium, factor concentrates and blood products. Additionally, recommendations are given on the topics of cell salvage, controlled hypotension and restrictive transfusion triggers.
authors.affiliation: Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln.
authors.forename: Heiko
authors.initials: H
authors.lastname: Lier
authors.affiliation: Klinik für Geburtsmedizin, Vivantes Klinikum Neukölln, Berlin.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Schlembach
authors.affiliation: Zentrum für Labormedizin, Hämostase- und Hämophiliezentrum, St. Gallen.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Korte
authors.affiliation: Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Vivantes Klinikum im Friedrichshain, Berlin.
authors.forename: Christian
authors.initials: C
authors.lastname: von Heymann
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Susanne
authors.initials: S
authors.lastname: Steppat
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Maritta
authors.initials: M
authors.lastname: Kühnert
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Holger
authors.initials: H
authors.lastname: Maul
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Henrich
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Werner
authors.initials: W
authors.lastname: Rath
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wacker
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Franz
authors.initials: F
authors.lastname: Kainer
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Daniel
authors.initials: D
authors.lastname: Surbek
authors.affiliation: PPH-Leiliniengruppe.
authors.forename: Hanns
authors.initials: H
authors.lastname: Helmer
mesh_terms: D001803:Blood Transfusion / Q000592:standards*; D019411:Clinical Laboratory Techniques / Q000592:standards*; D019317:Evidence-Based Medicine; D005858:Germany; D006176:Gynecology / Q000592:standards; D006489:Hemostatic Techniques / Q000592:standards*; D009774:Obstetrics / Q000592:standards; D006473:Postpartum Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome