Diagnosis and management of postpartum haemorrhage

TP and/or EP3 receptors mediate the vasoconstrictor and pressor responses of prostaglandin F 2α in mice and/or humans

“…Prostanoid synthesis drastically increases in uteri during the late stage of pregnancy, leading to the activation of F prostanoid receptor (FP), a prototype PGF 2a receptor that mediates uterine smooth muscle contraction required for the initiation of parturition (3)(4)(5)(6)(7)(8). Indeed, PGF 2a has been clinically used as a therapeutic for uterine atony, a major cause of postpartum hemorrhage that leads to maternal morbidity (9). However, its concurrent vasoconstrictor and/or pressor effects limit its clinical use, such as treating patients with hypertension (9).…”

Contemporary Issues in Women's Health

“…Postpartum hemorrhage, defined as a blood loss of more than 500 mL from the genital tract after the delivery of the fetus vaginally, and more than 1000 mL after abdominal delivery, accounts for 25% of maternal deaths worldwide . In 80% of women with postpartum hemorrhage during the first 24 hours of delivery, the cause is uterine atony.…”

“…In 80% of women with postpartum hemorrhage during the first 24 hours of delivery, the cause is uterine atony. An obstetric shock index (pulse rate divided by the systolic blood pressure) of more than 1 has been used to indicate the need for immediate management …”

“…Oxytocin is used in most countries; it has fewer side effects compared with ergometrine, which is also considered as first‐line treatment in some countries. Oxytocin induces myometrial contraction and retraction, and increases basal uterine tone, whereas ergometrine produces arterial vasoconstriction and myometrial contraction . Other uterotonic agents used in the prevention and treatment of postpartum hemorrhage include prostaglandins F2a, carbetocin, and combination oxytocin/ergometrine …”

Expecting the unexpected: Acquired haemophilia A in a patient with homozygous factor V deficiency

“…Postpartum AHA accounts for 2%‐21% of cases, is more common in primigravidae and typically presents with major bleeding within the first 3 months after delivery . Postpartum haemorrhage (PPH) is not uncommon, and bleeding during this period may be attributed to obstetric causes, such as uterine atony . This may delay the diagnosis of AHA and contributes to the morbidity and mortality of this condition.…”