Common errors and remedies in managing postpartum haemorrhage

Lombaard, Hennie; Pattinson, Robert Clive

doi:10.1016/j.bpobgyn.2009.01.006

Cited by 26 publications

(26 citation statements)

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“…However, in the majority of cases of PPH secondary to uterine 'atony', when uterotonic agents are used they are clinically successful. 6,7 Recently, uterine tamponade using balloon technology has been employed in the management of PPH. 13 This involves the insertion of a balloon made of rubber or silicone into the uterine cavity and incremental inflation of the balloon with normal saline.…”

Section: Discussionmentioning

confidence: 99%

Intraluminal pressure readings during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage

Georgiou

2010

BJOG

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Please cite this paper as: Georgiou C. Intraluminal pressure readings during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage. BJOG 2010;117:295–303. Objective To investigate the proposed mechanism by which intrauterine balloons achieve their tamponade effect of creating an ‘intrauterine pressure that is greater than the systemic arterial pressure’. Design To determine the intraluminal pressures within a Bakri balloon during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage. To correlate these intraluminal pressures with contemporaneous readings of blood pressure recordings as documented from the operating theatre anaesthetic charts. Setting An obstetric unit (approximately 2400 births) in Wollongong, New South Wales, Australia. Sample Two women in whom first‐line uterotonics were unsuccessful and who required a Bakri balloon to control postpartum haemorrhage secondary to an atonic uterus. Methods A DigiMano (Netech Corporation, Farmingdale, NY, USA) pressure recorder was attached via a three‐way tap to a Bakri balloon. Anaesthetic charts of the two cases were reviewed retrospectively. Main outcome measures Intraluminal pressure readings were recorded after each 50‐ml aliquot of normal saline had been insufflated into the balloon whilst the next aliquot was being prepared. Results There is a curvilinear relationship between the intraluminal pressure and the balloon volume. The pressure does not exceed the systolic blood pressure of the patient at the time of establishment of a positive tamponade test. Conclusions The intraluminal pressure within the tamponade balloon does not exceed the systolic blood pressure of the patient when a positive tamponade test is established.

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Section: Discussionmentioning

confidence: 99%

Intraluminal pressure readings during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage

Georgiou

2010

BJOG

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“…According to the study of MM in France (2013) [9], a 10-year period of inadequate assistance of 80-90% was determined fatal in women with obstetric hemorrhage and hypertensive disorders. According to H. Lombaard et al (2009), in the cases of MM from postpartum haemorrhage, inadequate medical assistance was more often registered.…”

Section: Discussionmentioning

confidence: 99%

“…The most frequent omissions and unrecorded features: late admission to the hospital in a state of hemorrhagic shock -40%, late deliveries -31%, delayed cesarean section -27%, bleeding after cesarean section -25%, the incorrect choice of operation volume -22%, underestimation of blood loss is 52%, the failure of the protocols is 54%, not produced by surgical method to stop bleeding at 12%, is not installed the source of bleeding was 6% [6].…”

Section: Discussionmentioning

confidence: 99%

Obstetric Hemorrhage Is as One of the Causes of Maternal Deaths

Akperbekova¹,

Abdullaev²

2017

J. res. health sci.

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Obstetric hemorrhage as a cause of maternal morbidity and mortality, over a long period it is one of the leading places in the world and among the five major causes of maternal mortality (MM). We aimed to analyze the reasons for MM in obstetric hemorrhage and to determine the complex of measures on prevention of maternal mortality from obstetric hemorrhage. Clinical, 45retrospective clinical and statistical analysis of data were studied in 67 stories of births ended in maternal mortality from obstetric hemorrhage. The dead women were aged 20-29 years-38 (57%), 30-35 -19 (28%), over 36 -10 (15%). By parity of predominated over repeatedly pregnant. The first pregnancy was 23 (34.3%), repeatedly pregnancy -25 (37.3%) and multiple pregnant women -19 (28.4%). Causes of bleeding were placenta abruption -in 31 (46%), placenta previa in 2(3%), Hypo -or atonic bleeding in 24 (36%), injuries of the birth canal -in 6(9%), intra-abdominal vascular bleeding -2 (3%), coagulopathies bleeding -in 1 (1.5%) women. Bleeding due to an ectopic pregnancy in 1 (1.5%). Bleeding in the late postpartum period occurred in 5 (8%) women. Bleeding is diagnosed late in 4 due to the fact that in 3 cases, the women were not observed after birth (14%) and in 1 case (1.5%) -after the surgery. The most frequent omissions and unrecorded features were late admission to hospital in the state of hemorrhagic shock in 40%. Late deliveries were in 31%; delayed cesarean section were in 27%; bleeding after cesarean section was in 25%; wrong choice of surgery volume in 22%; underestimation of blood loss in 52%; non-compliance with protocols in 54%, non-surgical method for stopping bleeding was 12%, not the source of bleeding was 6%. These data indicate the need to improve emergency care in maternity institutions. We can deduce the following recommendations for the prevention of mortality from hemorrhage: improvement of antenatal care and the treatment of pregnant women of groups with risk factors for bleeding, in the first place, suffering extragenital diseases and training of obstetricians and gynecologists.

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“…Delay in establishing diagnosis, failure to carry out appropriate intervention and lack of team effort had been associated with poor maternal outcomes (Siassakos et al, 2009 (Lombaard & Pattinson, 2009). …”

Section: Trainingmentioning

confidence: 99%