Antifibrinolytic drugs for treating primary postpartum haemorrhage

Shakur, Haleema; Beaumont, Danielle; Pavord, Sue; Gayet-Ageron, Angèle; Ker, Katharine; Mousa, H.

doi:10.1002/14651858.cd012964

Cited by 75 publications

(82 citation statements)

References 47 publications

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“…Indeed, for women and babies who do have diseases or complications, this type of research is critical. For example, the evidence on the efficacy of magnesium sulphate to prevent pre-eclampsia and to treat eclampsia [14] and the use of tranexamic acid for catastrophic haemorrhage [15] have saved many lives around the world. However, the large majority of the 130 million women who give birth annually do not require medical procedures or pharmacological agents to safely complete a process that has been shaped by complex adaptive evolution-a process that is critical to the survival of the human race.…”

Section: Current Norms In Childbirth and Related Researchmentioning

confidence: 99%

Understanding childbirth as a complex salutogenic phenomenon: The EU COST BIRTH Action Special Collection

et al. 2020

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In 2014, the EU funded a four-year European Cooperation in Science and Technology (COST) Action to address the topic of childbirth. The COST Birth Action was a cross-European network, that brought together over 120 scientists, practitioners, activists and policy makers from 34 countries to work on intrapartum care. The central aim was to advance the state of research and practice in a specific area of great clinical and social importance, intrapartum care. The Action used inter and trans-disciplinary approaches to address birth from multiple perspectives and drew on complexity theory and the concept of salutogenesis (wellbeing). This special collection presents six papers produced from the Action and gives a sense of the range and depth of the work conducted. The Collection illustrates the knowledge that can be generated when a diverse group of people come together with a similar goals and perspectives. Underpinning theory of the action The underpinning scientific framework of the Action [1] was complexity theory, applied through the lens of Sackett's multi-system complex adaptive notion of EBM. In contrast to most research in the intrapartum period, it was also designed to explore childbirth from a salutogenic (wellbeing) perspective, with a particular focus on the salutogenic concept of 'sense of coherence'. Complexity theory The promise of classical enlightenment science has been that scientific method based on the idea that A causes B, (a linear hypothesis) can be used to uncover what is true. The belief underpinning this hypothesis is through scientific progress, we will eventually know everything there is to know about the world [2]. The academic and engineering discoveries resulting from this approach led to the marvels of the industrial revolution and a huge number of social and health care improvements. However, over the last thirty years or so there has been a significant move away from reliance on simple linear calculations undertaken in disciplinary silos,

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Section: Current Norms In Childbirth and Related Researchmentioning

confidence: 99%

Understanding childbirth as a complex salutogenic phenomenon: The EU COST BIRTH Action Special Collection

et al. 2020

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“…Aware of the forthcoming WOMAN Trial findings, the Guideline Steering Group prioritised this question for urgent updating. A new Cochrane review of antifibrinolytics for PPH treatment was rapidly initiated 61 as an offshoot of the existing Cochrane review on PPH treatments 62. The new review identified only two trials that compared the use of any fibrinolytic drug with no treatment in women with PPH, and findings were dominated by the WOMAN Trial 60.…”

Section: Step 5: Developing Recommendations With a ‘Living’ Guidelinementioning

confidence: 99%

Developing and applying a "living guidelines" approach to WHO recommendations on maternal and perinatal health

et al. 2019

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How should the WHO most efficiently keep its global recommendations up to date? In this article we describe how WHO developed and applied a ‘living guidelines’ approach to its maternal and perinatal health (MPH) recommendations, based on a systematic and continuous process of prioritisation and updating. Using this approach, 25 new or updated WHO MPH recommendations have been published in 2017–2018. The new approach helps WHO ensure its guidance is responsive to emerging evidence and remains up to date for end users.

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“…However, the evidence for the timing and nature of surgical interventions is mostly from expert opinion or based on case series which are included as the evidence. 24,25,26,27,28 Most evidence for success of balloon tamponade, which is widely used, is based on case reports but two recent RCTs suggest lack of efficacy and increased risk of adverse outcomes. 25,30 Balloon tamponade is included in the algorithm pending more research with the proviso that it should be a temporising rather than therapeutic measure and abandoned if it fails to control bleeding within 20 minutes.…”

Section: 35mentioning

confidence: 99%

“…Similarly, laparotomy and further surgical measures are required, as already described for algorithm 2, if medical and BT fails to control the bleeding. 16,17,18,19,20,26,27,28,35,43 If MROP is complicated due to morbid adherence, it may require uterine curettage under ultrasound, specialist advice and assistance if available; and laparotomy for conservative surgical measures or hysterectomy, if the skill is available.…”

Section: 35mentioning

confidence: 99%

Algorithms for managing third stage abnormalities

Marcus¹,

Fawcus²

2020

Preprint

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The development of clear approaches to the assessment, resuscitation, treatment and monitoring of the four case scenarios are presented as algorithms, based on available evidence. They need to be field tested, and adapted for Artificial intelligence and different settings. Further research is needed around multimodal sequential care package of care for PPH, conservative surgical measures, resuscitation in LMICs, and the psychological impact of PPH on women.

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Antifibrinolytic drugs for treating primary postpartum haemorrhage

Cited by 75 publications

References 47 publications

Understanding childbirth as a complex salutogenic phenomenon: The EU COST BIRTH Action Special Collection

Understanding childbirth as a complex salutogenic phenomenon: The EU COST BIRTH Action Special Collection

Developing and applying a "living guidelines" approach to WHO recommendations on maternal and perinatal health

Algorithms for managing third stage abnormalities

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