Massive obstetric haemorrhage

Bonnar, J.

doi:10.1053/beog.1999.0060

Cited by 201 publications

(113 citation statements)

References 22 publications

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“…2 Serious morbidity arising from PPH also includes but is not limited to hysterectomy, hypovolemic shock, disseminated intravascular coagulopathy, renal failure, hepatic failure, adult respiratory distress syndrome, and Sheehan's syndrome. 3 Global initiatives to reduce maternal mortality and to decrease maternal morbidity in obstetrics have focused on strategies for the management of PPH, specifically emphasizing the active management of the third stage of labor, including the use of uterotonics immediately after the birth of the baby. 4 The need for standardized treatment protocols has been emphasized recently, although which uterotonics should be used remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage

Korst

Fridman³

et al. 2009

J Perinatol

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Objective: To identify women who are most likely to benefit from primary prevention strategies for postpartum hemorrhage (PPH).Study Design: In a retrospective patient cohort, we applied recursive partitioning algorithms to identify the most discriminant risk factors and their interactions, and calculated the 'number needed to treat' to prevent a single case of PPH (estimated blood loss >1000 ml).Result: By delivery category, the highest risk groups with 'number needed to treat' ranging from 4 to 7 were: (1) vaginal delivery (PPH ¼ 0.7% of 16 218)Fmacrosomia with gestational diabetes and manual removal of the placenta; (2) primary cesarean (PPH ¼ 18.7% of 2696)Fmacrosomia and multiparity; and (3) repeat cesarean (PPH ¼ 16.0% of 1832)Futerine incision other than low transverse and failed vaginal birth after cesarean. Conclusion:Clinical profiles that identify women at risk for PPH can provide a foundation for the development of primary prevention strategies.

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Section: Introductionmentioning

confidence: 99%

Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage

Korst

Fridman³

et al. 2009

J Perinatol

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“…Even in developed countries, hemorrhage is still among the main causes of maternal morbidity [9]. According to WHO analysis, hemorrhage constitutes 33.9% of maternal deaths in Africa and 30.8% in Asia [10]. In both developed and developing countries, 60% of maternal mortality occurred in the post partum period, 45% occurred during the first day of delivery, 65% within the first week and 80% within two weeks [11].…”

Section: Discussionmentioning

confidence: 99%

Reducing Maternal Mortality from Direct Obstetric Causes during 2013 in Sudan

Umbeli¹,

Ismail²,

AbdAlla³

et al. 2014

UCMS

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Despite the worldwide commitment to improve maternal health, measuring, monitoring and comparing mortality estimates remain a challenge. This study was done to assess maternal mortality from direct obstetric causes (obstetric haemorrhage, hypertensive disorders and sepsis) after suitable interventions in Sudan during 2013. Facility and community-based MDR (maternal death review) was conducted in Sudan since 2009. National and states' MDRCs (Maternal Death Review Committees) were established. A focal person for each state, health facility and locality was nominated. Notification of MD (maternal deaths) was done by telephone, followed by review of all notified maternal deaths using a structured format. Recommendations for reducing MM (maternal mortality) from obstetric haemorrhage, hypertensive disorders and sepsis have been generated. Management protocols, training of care providers and availing of necessary requirements for these cases have been approved and implemented in all states. Reported MD were reviewed and analyzed using SPSS, version 18.0 and the resulting MMR (maternal mortality ratio) was compared with years 2010-2012 to assess improvement. During 2013, 1,110 maternal deaths were notified, out of 645,881 LB (live births). MMR was 172/100,000 LB, with different variation between states. Facility maternal deaths were 937 (84.4%) and community deaths were 173 (15.6%). Direct obstetric deaths were 678 (61.1%), mainly due to haemorrhage 311 (28.0%), hypertensive disorders 116 (10.5%) and sepsis 110 (9.9%). Indirect causes were 432 (38.9%), mainly due to hepatitis and anemia. Most of the hospital deaths 707 (75.5%) were admitted late from home and 559 (59.7%) died within 24 hours. MDs from hypertensive disorders and sepsis decreased significantly, while MDs from haemorrhage are persistently high compared to 2010-2012. Home delivery, late presentation, unavailability of blood and poor referral system, are the main factors behind maternal deaths. MDs from hypertensive disorder and sepsis decreased significantly, while MDs from haemorrhage are persistently high.

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“…The complications of MPPH include hypovolemic shock, DIC, renal failure, hepatic failure and ARDS. Factors infl uencing the outcome are: underestimation of blood loss, late diagnosis of uterine rupture, undiagnosed concealed abruption, late diagnosis of retroperitoneal or intra abdominal bleeding, rapid changes of coagulation events, inability to accurately diagnose the severity of DIC and the lack of ideal hospital facility [5].…”

Section: Postpartum Hemorrhage -An Obstetric Emergency In Perspectivementioning

confidence: 99%

Recombinant factor VIIa: use in fatal post partum hemorrhage — Indian experience case series and review of literature

Singi

Fernández

Pandya

et al. 2009

Indian J Hematol Blood Transfus

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Postpartum hemorrhage is leading cause of maternal mortality and still remains a challenging condition to treat and hysterectomy may be required to control the bleeding once medical interventions fail. These strategies are not always successful and a direct approach in activating the coagulation system can be more effective and life saving. We describe here the mechanism of action of rFVIIa, review of literature and its use in 10 cases with different causes for PPH with good response.

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Massive obstetric haemorrhage

Cited by 201 publications

References 22 publications

Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage

Identifying women most likely to benefit from prevention strategies for postpartum hemorrhage

Reducing Maternal Mortality from Direct Obstetric Causes during 2013 in Sudan

Recombinant factor VIIa: use in fatal post partum hemorrhage — Indian experience case series and review of literature

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