Postpartum hemorrhage: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF)

Sentilhes, Loïc; Vayssière, Christophe; Deneux‐Tharaux, Catherine; Aya, Antoine G. M.; Bayoumeu, F.; Bonnet, Marie‐Pierre; Djoudi, Rachid; Dolley, P.; Dreyfus, Michel; Ducroux-Schouwey, Chantal; Dupont, C.; François, Anne Isabelle; Gallot, Denis; Haumonté, Jean-Baptiste; Huissoud, Cyril; Kayem, Gilles; Keïta, H.; Langer, B.; Mignon, Alexandre; Morel, Olivier; Parant, Olivier; Pelage, Jean-Pierre; Phan, E.; Rossignol, Mathias; Tessier, V.; Mercier, F.J.; Goffinet, François

doi:10.1016/j.ejogrb.2015.12.012

Cited by 270 publications

(249 citation statements)

References 18 publications

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“…The most recent French guidelines recommend transfusion in the setting of postpartum hemorrhage in order to maintain a Hb concentration .8 g/dL. 111 The latest transfusion guidelines of the AABB (formerly the American Association of Blood Banks) are based on 12 587 patients enrolled in 31 eligible randomized controlled trials in nonobstetric settings. They recommend using a restrictive Hb transfusion threshold of 7 g/dL for hemodynamically stable hospitalized adult patients.…”

Section: Rbc Transfusions In Pregnancymentioning

confidence: 99%

How I treat anemia in pregnancy: iron, cobalamin, and folate

Achebe

Gafter‐Gvili

2017

Blood

137

130

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Anemia of pregnancy, an important risk factor for fetal and maternal morbidity, is considered a global health problem, affecting almost 50% of pregnant women. In this article, diagnosis and management of iron, cobalamin, and folate deficiencies, the most frequent causes of anemia in pregnancy, are discussed. Three clinical cases are considered. Iron deficiency is the most common cause. Laboratory tests defining iron deficiency, the recognition of developmental delays and cognitive abnormalities in iron-deficient neonates, and literature addressing the efficacy and safety of IV iron in pregnancy are reviewed. An algorithm is proposed to help clinicians diagnose and treat iron deficiency, recommending oral iron in the first trimester and IV iron later. Association of folate deficiency with neural tube defects and impact of fortification programs are discussed. With increased obesity and bariatric surgery rates, prevalence of cobalamin deficiency in pregnancy is rising. Low maternal cobalamin may be associated with fetal growth retardation, fetal insulin resistance, and excess adiposity. The importance of treating cobalamin deficiency in pregnancy is considered. A case of malarial anemia emphasizes the complex relationship between iron deficiency, iron treatment, and malaria infection in endemic areas; the heightened impact of combined etiologies on anemia severity is highlighted.

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Section: Rbc Transfusions In Pregnancymentioning

confidence: 99%

How I treat anemia in pregnancy: iron, cobalamin, and folate

Achebe

Gafter‐Gvili

2017

Blood

137

130

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“…5 In the recently updated French postpartum hemorrhage guidelines, contrary to what is mentioned in the conclusion of the abstract by Frimat et al, 1 the recommendation is cautious and states that because of weak evidence regarding TXA efficacy in obstetrics and the potential safety issue, its use is left to the clinician's discretion, and also any use should be limited to a dose of 1 g, renewable once if ineffective. 6 The new evidence provided by Frimat et al further supports this recommendation. It seems reasonable to discourage prolonged administration of TXA to treat postpartum hemorrhage until the risk-benefit balance of this drug in the obstetrics context is better documented.…”

Section: To the Editormentioning

confidence: 51%

Risk of Tranexamic Acid for Treatment of Postpartum Hemorrhage

Sentilhes

Goffinet

Deneux‐Tharaux

2017

American Journal of Kidney Diseases

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“…fresh frozen plasma, cryoprecipitate) or uterotonics (e.g. oxytocin, misoprostol) (10,11). Developing fever following blood product replacement has been reported in publications (12,13 as misoprostol also trigger fever in some women with an unclear reason (14).…”

Section: Introductionmentioning

confidence: 99%

Exploring the Postpartum Pyrexia Related to Inherited Coagulopathies in a Cohort of Iranian Women

Shahbazi

Moghaddam-Banaem

2017

Women Health Bull

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Background: Postpartum pyrexia results from various causes with bacterial infection heading the list. However, there are many other possible causes such as bleeding. Congenital deficiency of the coagulation factors causes inherited coagulopathies most of which are rare. Following delivery, the reduction in coagulation factors puts these mothers at greater risk of postpartum excessive bleeding. Objectives: We aimed to assess postpartum pyrexia in bleeding disorder mothers. Methods: This study was conducted on 98 bleeding disorder patients and 199 controls. Using a standardized questionnaire, the data were collected by consulting a specialist. The subject's medical records during pregnancy and labor were also reviewed. Postpartum fever was defined as temperature > 38°C in the first 10 days after delivery excluding the first day. The data were analyzed using Chisquare statistical analysis and P < 0.05 was considered statistically significant. Results: Postpartum pyrexia was detected in 11.2% of the patients compared to 4% of the controls. The statistical analysis revealed a significantly higher incidence of postpartum fever among the coagulation disorder patients (P = 0.019). Considering the infection, our data showed that in the patient group, fever was mostly due to (unknown) reasons other than infection. Conclusions: Our results revealed that besides hemorrhagic complications in inherited bleeding disorders, postpartum fever could also be a sign of threat. Early identification and diagnosis of these threats greatly improve the childbirth outcomes in high-risk mothers.

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Postpartum hemorrhage: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF)

Cited by 270 publications

References 18 publications

How I treat anemia in pregnancy: iron, cobalamin, and folate

How I treat anemia in pregnancy: iron, cobalamin, and folate

Risk of Tranexamic Acid for Treatment of Postpartum Hemorrhage

Exploring the Postpartum Pyrexia Related to Inherited Coagulopathies in a Cohort of Iranian Women

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