Abstract
Severe peripartum hemorrhage (PPH) contributes to maternal morbidity and mortality and is one of the most frequent emergencies in obstetrics, occurring at a prevalence of 0.5-5.0%. Detection of antepartum risk factors is essential in order to implement preventive measures. Proper training of obstetric staff and publication of recommendations and guidelines can effectively reduce the frequency of PPH and its resulting morbidity and mortality. Therefore, an interdisciplinary expert committee was formed, with members from Germany, Austria, and Switzerland, to summarize recent scientific findings. An up-to-date presentation of the importance of embolization and of the diagnosis of coagulopathy in PPH is provided. Furthermore, the committee recommends changes in the management of PPH including new surgical options and the off-label use of recombinant factor VIIa.
Publication types
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Practice Guideline
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Research Support, Non-U.S. Gov't
MeSH terms
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Austria
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Blood Transfusion
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Causality
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Coagulants / therapeutic use
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Comorbidity
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Disseminated Intravascular Coagulation / diagnosis
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Disseminated Intravascular Coagulation / epidemiology
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Disseminated Intravascular Coagulation / therapy
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Embolization, Therapeutic
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Factor VII / therapeutic use
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Female
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Germany
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Humans
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Hysterectomy
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Methylergonovine / therapeutic use
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Oxytocics / therapeutic use
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Oxytocin / therapeutic use
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Placenta, Retained / epidemiology
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Placenta, Retained / therapy
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Postpartum Hemorrhage / diagnosis*
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Postpartum Hemorrhage / epidemiology
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Postpartum Hemorrhage / therapy*
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Pregnancy
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Pregnancy Complications, Hematologic / epidemiology
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Pregnancy Complications, Hematologic / therapy
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Prostaglandins / therapeutic use
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Risk Factors
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Suture Techniques
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Switzerland
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Uterine Inertia / epidemiology
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Uterine Inertia / therapy
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Uterine Rupture / epidemiology
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Uterine Rupture / therapy
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Uterus / pathology
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Uterus / surgery
Substances
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Coagulants
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Oxytocics
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Prostaglandins
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Oxytocin
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Factor VII
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Methylergonovine