Getting an evidence‐based post‐partum haemorrhage policy into practice

Cameron, Carolyn A.; Roberts, Christine L.; Bell, Jane C.; Fischer, Wendy

doi:10.1111/j.1479-828x.2007.00713.x

Cited by 37 publications

(18 citation statements)

References 9 publications

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“…We hope that other institutions will take the data presented here, along with the resources that are readily available from other online sources 20,28 and produce hemorrhage response systems that will be tailored to their facility. Based on the success of the protocol presented here and reported elsewhere, 27,28,[36][37][38][39] the primary goals of those endeavors should include (1) enhanced communication with all members of the hospital who may be part of the treatment team, (2) on-going staff education regarding key elements of the protocol. (3) blood loss assessment training, (4) standardized treatment that changes as the acuity of the patient changes and prevents repeated use of ineffective intervention, (5) early requirement for physician (obstetric and anesthesia) bedside assessment, and (6) early intervention with fixed ratios of blood products.…”

Section: Commentmentioning

confidence: 99%

Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety

Shields

Wiesner

Fulton

et al. 2015

American Journal of Obstetrics and Gynecology

244

149

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Section: Commentmentioning

confidence: 99%

Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety

Shields

Wiesner

Fulton

et al. 2015

American Journal of Obstetrics and Gynecology

244

149

View full text Add to dashboard Cite

“…A total of nine references that addressed the issue of postpartum hemorrhage management in a survey format were identified. None of the identified references addressed the national trends of postpartum management in the United States and only one of the references dealt with current evidence-based practice and recommendations [22]. Therefore, we conducted a survey developed by one of the authors (MJP) of a national sample of obstetricians (OB/GYNs) to describe the current treatment strategies relative to postpartum hemorrhage.…”

Section: Methodsmentioning

confidence: 99%

A Survey of Current Treatment Practices for Postpartum Hemorrhage by Practicing Obstetricians and Hematologists

Triche¹,

Wehrum²,

Paidas³

2014

OJOG

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Objective: To identify current treatment strategies for postpartum hemorrhage used by obstetricians (OB/GYNs) and hematologists (HEMs). Study Design: We conducted a survey of OB/GYNs (n = 220) and HEMs (n = 30) to describe the characteristics of current treatment strategies for postpartum hemorrhage. Surveys were administered via a structured questionnaire on a secure internet website from 5 -12 October 2009. Results: The majority of OB/GYN and HEM respondents were practicing in a community hospital environment (77%). Of the OB/GYNs, the majority practiced at hospitals with over 2000 deliveries per year (77%). A majority (58%) of OB/GYNs were affiliated with hospitals that lacked a massive transfusion protocol to treat severe postpartum hemorrhage. Subsequent to uterine massage and additional oxytocin, the majority of OB/GYNs (73%), preferred the administration of Methergine ® as the next level of intervention for postpartum hemorrhage. There was considerable variability in response to specific treatment strategies for several hypothetical case scenarios; however, the large majority of OB/GYNs favored obstetrical procedures over interventional radiology or administration of rFVIIa. A large majority (77%) of physicians who are familiar with rRVIIa as treatment for postpartum hemorrhage reported being very satisfied with the agent for this indication. Conclusions: An established, systematic treatment strategy among OB/GYNs emerged only in the case of mild postpartum hemorrhage.

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“…Cameron et al concluded in his study that Postpartum Hemorrhage is a potentially lifethreatening complication of childbirth occurring in up to 10% of birth. 8 Shamoona from Federal Government Services Hospital, Islamabad, reported a frequency of 3.7%-8.6%. 9 Roohi et al showed frequency of 13% in her study done in Punjab Medical College and its affiliated hospital Faisalabad.…”

Section: Discussionmentioning

confidence: 99%

Postpartum Hemorrhage; Efficacy of Balloon Tamponade in the Management

Zafar¹,

Shaukat²,

Khalid³

et al. 2017

TPMJ

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… Primary postpartum hemorrhagic, rightly called as obstetrician's nightmare, refers to excessive blood loss of more than 500ml during the third stage of labour or in the first 24 hours after delivery. It continues to be one of the leading causes of maternal mortality and morbidity all over the world including Pakistan where it is responsible for 21-31% of maternal mortality and morbidity. Objectives: Objective of study was to determine the efficacy of balloon tamponade in the management of primary PPH, so that a low cast, easy to use technology is available for conserving future fertility by treating postpartum hemorrhage. Settings: Department of Gynae & Obs, Allied Hospital, Faisalabad. Study Design: Descriptive cross sectional study. Study Period: 6 months from 1 st Oct, 2015 to 31 st March, 2016. Material & Methods: All patients delivered vaginally at term (after 37 completed weeks of gestation) who developed PPH due to uterine atony after failure of conventional medical therapy were included in this study. Patient selection was based on inclusion and exclusion criteria. Their demographic profile and efficacy of balloon tamponade was checked in terms of time required to control hemorrahage and need of laparotomy. Results: During study period total no. Of vaginal deliveries were 3000. Out of these 298 developed PPH, 220 had PPH due to uterine atony and did not respond to conventional medical therapy. The age of patients ranged between 22 and 40 years with mean age of 30 year (±4.88SD). The parity of the patients ranged between 1 and 14 with the mean parity of 4 (±2.26SD). The condom catheter was introduced in all the selected 80 patients and was successful in 73 patients. Conclusions: In developing countries such as Pakistan where the maternal death rate from PPH is very high, this safe, in expensive and easy procedure (it does not require any expertise) can be applied in any situation to save a life and to save the uterus in young patients to conserve reproductive capacity and prevent them from surgery and its morbidity. This will protect the patients from irreversible shock and even death with a success rate of 85-95%.

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Getting an evidence‐based post‐partum haemorrhage policy into practice

Cited by 37 publications

References 9 publications

Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety

Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety

A Survey of Current Treatment Practices for Postpartum Hemorrhage by Practicing Obstetricians and Hematologists

Postpartum Hemorrhage; Efficacy of Balloon Tamponade in the Management

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