Management der postpartalen Blutung (PPH)

Schlembach, Dietmar; Mörtl, M; Girard, Thierry; Arzt, W; Beinder, Ernst; Brezinka, C; Chalubinski, Kinga; Fries, Dietmar; Gogarten, W.; Hackelöer, Bernhard-Joachim; Helmer, Hanns; Henrich, Wolfgang; Hösli, Irène; Husslein, P.; Kainer, Franz; Lang, Uwe; Pfanner, G.; Rath, Werner; Schleußner, E; Steiner, H.; Surbek, Daniel; Zimmermann, Roland

doi:10.1007/s00101-014-2291-1

Cited by 47 publications

(11 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 a Total number of deliveries from 1998-2016; b deliveries from 1998-2016 according to delivery mode (SVD spontaneous vaginal delivery, Instrumental VD instrumental vaginal delivery, CS Cesarean section) despite this increase, excessive RBC administration in the acute and subacute phase in Switzerland has been decreasing after 2012. This is in line with the implementation of Swiss guidelines on PPH and anemia in pregnancy [4,20,23]. Nevertheless, there was an increase in the administration of one to two RBC units.…”

Section: Discussionsupporting

confidence: 76%

“…Multiple obstetric guidelines exist for PPH management, while in Switzerland, Germany, and Austria an universal guideline for PPH treatment was introduced by obstetric societies [4]. One important update of those guidelines occurred in 2012, re-evaluating the application of conservative and surgical treatment of PPH, including RBC administration [23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Red blood cell transfusion in obstetrics and its implication for patient blood management: a retrospective analysis in Switzerland from 1998 to 2016

Zdanowicz

Schneider

Mueller

et al. 2020

Arch Gynecol Obstet

View full text Add to dashboard Cite

Purpose Peripartum hemorrhage (PPH) remains one of the main causes of maternal mortality worldwide. Treatment includes administration of packed red blood cells (RBC) in severe cases and patient blood management (PBM) may reduce it significantly. In our study, we wanted to retrospectively assess red blood cell administration in PPH to evaluate the impact of PBM in Switzerland. Methods Using data from the Swiss obstetric hospital registry (Arbeitsgemeinschaft Schweizer Frauenkliniken, ASF), we included patients with deliveries from 1998 to 2016. We examined available obstetric data as well as blood loss and RBC administration in the acute and subacute peripartal phase. We categorized data into two time intervals: 1998-2011 and 2012-2016, as new PPH guidelines in Switzerland were established in 2012. Results PPH incidence increased between 1998 and 2016 significantly. The number of vaginal instrumental deliveries and cesarean sections increased as well. Administration of three or more RBC units, as defined in the ASF registry, in the acute and subacute phase in Switzerland has decreased after 2012. Conversely, we saw an increase in the administration of one to two RBC units in the acute and subacute phase. Nevertheless, overall RBC administration has been decreasing from 1998 to 2016. Conclusion The increase of patients obtaining one or two units of RBC for PPH suggests that there may be a potential for effective implication of PBM in obstetrics. Reduction of RBC transfusion in the context of PPH may not only decrease maternal morbidity, but decrease economic costs as well.

show abstract

Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Red blood cell transfusion in obstetrics and its implication for patient blood management: a retrospective analysis in Switzerland from 1998 to 2016

Zdanowicz

Schneider

Mueller

et al. 2020

Arch Gynecol Obstet

View full text Add to dashboard Cite

show abstract

“…Mortality due to PPH, which is still the leading cause of maternal death worldwide, was not observed in our cohort. This might be a result of effective treatment options and standardized PPH management [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes and trends of peripartum maternal admission to the intensive care unit

Farr

Lenz-Gebhart

Einig

et al. 2017

Wien Klin Wochenschr

View full text Add to dashboard Cite

SummaryBackgroundThe number of pregnant women with severe comorbidities is increasing. The aim of the present study was to analyze outcomes and determine trends in women who required peripartum admission to the intensive care unit (ICU).MethodsIn this retrospective study, we identified all women who were admitted to the ICU between the second trimester of pregnancy and 6 weeks postpartum. Women with ICU admission between 2011 and 2014 were assigned to the study group, whereas those admitted between 1996 and 2003 were assigned to the historical group. Comorbidities, characteristics, outcomes, and treatment efforts were assessed. Descriptive analysis, Fisher’s exact test, unpaired Student’s t-test and one-way ANOVA were performed.ResultsWe identified 238 cases, including 135 (56.7%) in the study group and 103 (43.3%) in the historical group. In 83 (34.9%) women, deterioration of the pre-existing medical condition was causal for ICU admission. Overall, preterm delivery and mean gestational age were 81.5% and 31.6 ± 6.2 weeks, respectively. In comparison to the historical group, women of the study group were older (p = 0.005), more frequently presented with multiple comorbidities (p = 0.003), pre-existing conditions (p < 0.001), and congenital heart disease (p = 0.012). Moreover, they had a shorter length of stay at the ICU than those of the historical group (p = 0.02).ConclusionsPeripartum ICU admissions are increasing in frequency. As maternal characteristics are changing, adequate risk stratification with multidisciplinary care are essential, and access to intermediate care units would be preferable for patients with short-term admission.

show abstract

“…During this interval, we reviewed the most recent PPH guidelines published by the following national obstetric societies (RCOG, 8 SOGC, 16 ACOG, 17 RANZCOG, 9 and CNGOF 18 ), an interdisciplinary group of experts from Austria, Germany, and Switzerland (D-A-CH), 19 and an international expert panel convened to develop consensus recommendations for PPH management (hereafter referred to as expert panel). 20 The goal of D-A-CH was to develop a PPH algorithm by reviewing guidelines from national societies in Austria, Germany, Switzerland, and other international PPH algorithms.…”

Section: Methodsmentioning

confidence: 99%

National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review

Shaylor

Weiniger

Austin

et al. 2017

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

In developed countries, rates of postpartum hemorrhage (PPH) requiring transfusion have been increasing. As a result, anesthesiologists are being increasingly called upon to assist with the management of patients with severe PPH. First responders, including anesthesiologists, may adopt Patient Blood Management (PBM) recommendations of national societies or other agencies. However, it is unclear whether national and international obstetric societies’ PPH guidelines account for contemporary PBM practices. We performed a qualitative review of PBM recommendations published by the following national obstetric societies and international groups: the American College of Obstetricians and Gynecologists; The Royal College of Obstetricians and Gynecologists, United Kingdom; The Royal Australian and New Zealand College of Obstetricians and Gynecologists; The Society of Obstetricians and Gynecologists of Canada; an interdisciplinary group of experts from Austria, Germany, and Switzerland; an international multidisciplinary consensus group; and the French College of Gynaecologists and Obstetricians. We also reviewed a PPH bundle, published by The National Partnership for Maternal Safety. On the basis of our review, we identified important differences in national and international societies’ recommendations for transfusion and PBM. In the light of PBM advances in the nonobstetric setting, obstetric societies should determine the applicability of these recommendations in the obstetric setting. Partnerships among medical, obstetric, and anesthetic societies may also help standardize transfusion and PBM guidelines in obstetrics.

show abstract

Management der postpartalen Blutung (PPH)

Cited by 47 publications

References 56 publications

Red blood cell transfusion in obstetrics and its implication for patient blood management: a retrospective analysis in Switzerland from 1998 to 2016

Red blood cell transfusion in obstetrics and its implication for patient blood management: a retrospective analysis in Switzerland from 1998 to 2016

Outcomes and trends of peripartum maternal admission to the intensive care unit

National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review

Contact Info

Product

Resources

About