title: Haemorrhage at caesarean section: a framework for prevention and research.
abstract: Caesarean section rates are increasing across the world. Postpartum haemorrhage is a major cause of morbidity and mortality; major haemorrhage is more common after caesarean delivery. There is a wide range of practice in the prevention and treatment of postpartum haemorrhage at caesarean section. The aim of this review is to summarize current opinion in the management of postpartum haemorrhage at caesarean section.
  
  
  
  Recent large randomized controlled trials have shown a possible effect from the routine use of tranexamic acid and ergometrine. Small randomized controlled trials have shown a possible benefit from using carbetocin.
  
  
  
  The impact of postpartum haemorrhage can be reduced by antenatal correction of anaemia. Intraoperative medical management consists of oxytocinon, additional oxytocics +/- tranexamic acid, with at present limited evidence as to the order in which these should be considered. Trials of routine use of cell salvage and tranexamic acid are currently underway.
authors: aRoyal London Hospital, Barts Health NHS Trust bWomen's Health Research Unit, Barts and the London School of Medicine, Queen Mary University of London cHillingdon Hospital, London, UK dDepartment of Obstetrics and Gynaecology, Trinity College, University of Dublin, Ireland eUniversity College London, London, UK.
authors: Jennifer E
authors: JE
authors: Jardine
authors: Penny
authors: P
authors: Law
authors: Matthew
authors: M
authors: Hogg
authors: Deirdre
authors: D
authors: Murphy
authors: Khalid S
authors: KS
authors: Khan
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects*; D004874:Ergonovine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010120:Oxytocics; D010121:Oxytocin / Q000031:analogs & derivatives / Q000627:therapeutic use; D006473:Postpartum Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D010120:Oxytocics; D010121:Oxytocin; C020731:carbetocin; D004874:Ergonovine