Management of major obstetric haemorrhage

Trikha, Anjan; Singh, Preet Mohinder

doi:10.4103/ija.ija_448_18

Cited by 35 publications

(36 citation statements)

References 18 publications

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“…The most significant risk factors for PP are previous CS and placenta praevia. [ 2 ] Imaging is used to diagnose PP antenatally. Ultrasound is the initial modality used.…”

Section: Introductionmentioning

confidence: 99%

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The management of patients with placenta percreta: A case series comparing the use of resuscitative endovascular balloon occlusion of the aorta with aortic cross clamp

2020

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Due to the rising caesarean section (CS) rate, there has been an increase in placenta percreta (PP) cases. Resuscitative endovascular balloon occlusion of the aorta (REBOA) use has been successful in obstetric surgery for PP. In our institution, it has been introduced for prophylactic and therapeutic management in patients with PP. In our environment, the risks, benefits, and associated cost of REBOA use needed to be determined. In this case series, we report on five patients with PP where REBOA or aortic cross clamp were used and examine the associated outcomes.

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“…The most significant risk factors for PP are previous CS and placenta praevia. [ 2 ] Imaging is used to diagnose PP antenatally. Ultrasound is the initial modality used.…”

Section: Introductionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) is complementary to ultrasound in assessing placental invasion of surrounding structures. [ 2 ] Antenatal diagnosis is critical to ensure timeous referral to a specialised center. A planned delivery with a multidisciplinary team (MDT) approach optimises outcomes.…”

Section: Introductionmentioning

confidence: 99%

The management of patients with placenta percreta: A case series comparing the use of resuscitative endovascular balloon occlusion of the aorta with aortic cross clamp

2020

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“…Approximately one‐quarter of maternal death are secondary to major obstetric haemorrhage (MOH), which refers to all kinds of excessive bleeding related to pregnancy and can occurs in the antepartum, during the delivery and in the postpartum period . The causes of MOH can be obstetric as well as systematic, such as placenta previa, placenta abruption, uterine atony and coagulopathies . According to the guidelines, treatment of MOH includes resuscitation and management of the underlying causes .…”

Section: Introductionmentioning

confidence: 99%

Blood transfusion‐related immunomodulation in patients with major obstetric haemorrhage

Jiao

Zheng

2019

Vox Sanguinis

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Background Blood transfusion is suggested to be immunosuppressive in surgical patients. However, the immunomodulatory effect of blood transfusion in obstetric patients with massive haemorrhage remains unknown.Methods Three hundred and fifty-five patients at active labour in the obstetric department were enrolled, and clinical characteristics were extracted from electrical medical records, inpatient notes, anaesthesia notes and discharge summaries. The transfused blood products included RBC, FFP and PLTs. RT-PCR was used to quantify gene expression in the blood samples, and the Spearman rank correlation coefficient was used to test correlation.Results Among the 355 patients, 138 received a diagnosis of obstetric haemorrhage and were treated with blood transfusion. The risk factors for blood transfusion included maternal age, gestational age, preterm labour and instrumental delivery. The infants delivered by the transfusion group had significantly lower birthweight and 1-and 5-min Apgar scores. Most importantly, blood transfusion is associated with a broad suppression of Th cells and an increased IL-10 response.Conclusions Our results show that blood transfusion is associated with immunomodulation in obstetric haemorrhage patients, suggesting more stringent criteria for blood transfusion should be taken into account in the obstetric haemorrhage patients.

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“…Additionally, fibrinogen levels fall quickly with PPH patients and this contributes to the coagulopathy of acute hemorrhage . Obstetric hemorrhage can have low mortality rates if caught early and managed properly …”

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confidence: 99%

Whole blood for postpartum hemorrhage: early experience at two institutions

Morris

Braverman²,

Corean

et al. 2020

Transfusion

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BACKGROUND Death from postpartum hemorrhage (PPH) remains a significant preventable problem worldwide. Cold‐stored, low‐titer, type‐O whole blood (LTOWB) is increasingly being used for resuscitation of injured patients, but it is uncommon in PPH patients, and it is unclear what its role may be in this population. STUDY DESIGN AND METHODS Brief report of the early experience of WB use for PPH in two institutions, one university hospital and one private hospital. RESULTS Different approaches have been implemented at the two institutions, one designed for emergency release, uncrossmatched transfusion of LTOWB as part of a massive transfusion protocol (MTP) and one for high‐risk obstetric patients with known placental abnormalities. A total of 7 PPH patients have received a total of 17 units of LTOWB between the two institutions. No severe adverse transfusion reactions were observed clinically in either institution and the clinical outcomes were favorable in all cases. CONCLUSION In our early experience, LTOWB can be implemented for two different PPH clinical scenarios. Larger studies are needed to compare outcomes between LTOWB and traditional component resuscitation strategies.

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Management of major obstetric haemorrhage

Cited by 35 publications

References 18 publications

The management of patients with placenta percreta: A case series comparing the use of resuscitative endovascular balloon occlusion of the aorta with aortic cross clamp

The management of patients with placenta percreta: A case series comparing the use of resuscitative endovascular balloon occlusion of the aorta with aortic cross clamp

Blood transfusion‐related immunomodulation in patients with major obstetric haemorrhage

Whole blood for postpartum hemorrhage: early experience at two institutions

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