Anesthesia technique and postpartum hemorrhage: a prospective cohort study

Borovac-Pinheiro, Anderson; Brandão, Maria José Nascimento; Argenton, Juliana Luz Passos; Barbosa, Thales Daniel Alves; Pacagnella, Rodolfo C.

doi:10.1016/j.bjane.2021.06.002

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…Uterine inversion requires anesthesia and uterine relaxation to facilitate manual replacement (Weiniger et al 2005). The effect of obstetric anesthesia on increasing the incidence of PPH was related to GA (Butwick et al 2017); however, several studies found no influence of obstetric anesthesia on PPH or its severity (Anderson et al 2022).…”

Section: Anticipated Postpartum Hemorrhagementioning

confidence: 99%

Updates in the perioperative management of postpartum hemorrhage

Samir

2023

Ain-Shams J Anesthesiol

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Background Postpartum hemorrhage (PPH) is the leading cause of maternal death all over the world. It could be primary or secondary with uterine atony being the cause in 80% of cases. Main body For anticipated PPH, special antenatal preparation for abnormal placentation, inherited coagulation disorders, and Jehovah’s Witnesses must be done. Optimal surgical management of placenta accreta is done by scheduling delivery in an appropriate surgical facility, by insertion of prophylactic embolization catheters in the uterine or internal iliac arteries, and by rapid diagnosis of PPH. The obstetric shock index (SI) is highly specific for PPH. Optimal anesthetic management is done by oxygen supply, using warming devices, ensuring wide bore intravenous (IV) access with adequate volume replacement, and blood product preparation. The non-pneumatic anti-shock garment (NASG) could be used as first-aid compression device. Permissive resuscitation, uterotonic administration, tranexamic acid, recombinant active factor seven (VIIa), and lyophilized fibrinogen concentrate are beneficial. Hemostatic reanimation to correct coagulopathy and cell saver auto-transfusion are applied. For unanticipated PPH, guidelines and regular skill training reduce the incidence of severe PPH. Conclusions Anticipated PPH requires antenatal preparation, optimal anesthetic management with the implementation of permissive resuscitation, hemostatic reanimation, and optimal surgical management.

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Section: Anticipated Postpartum Hemorrhagementioning

confidence: 99%

Updates in the perioperative management of postpartum hemorrhage

Samir

2023

Ain-Shams J Anesthesiol

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“…These studies have addressed a myriad of topics related to high-risk surgery, from measures to detect patients at higher risk for complications to strategies focused on providing enhanced perioperative care in high-risk surgical patients. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 …”

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confidence: 99%