The management of critical bleeding in obstetrics

Reviews in Health Care

View Publication Info
 
 
Field Value
 
Title The management of critical bleeding in obstetrics
 
Creator Lancé, Marcus D.
 
Subject Clinical Medicine
Post-partum hemorrhage (PPH); Therapy; Transfusion; Procoagulant and anticoagulant factors
 
Description Post-partum hemorrhage (PPH) is one of the most frequent causes of maternal death: worldwide it contributes for a 25% of deaths. The risk of death from pregnancy complications has decreased dramatically over the last few decades, but several evidences show they have not yet been reduced to a minimum. There is therefore the need for a further improvement in the quality of medical care. Purpose of this paper is to briefly outline an overview of the definition of PPH, with an illustration of the possible causes and treatments currently available. WHO defined PPH as excessive bleeding > 500 ml after vaginal delivery and severe PPH as bleeding in excess of 1,000 ml after vaginal delivery, but a variety of definitions for PPH have been proposed, yet no single satisfactory definition exists. Another crucial item regards the estimation of blood loss, too often based on a visual assessment and, therefore, inaccurate and minimized. However, in medical literature there are no specific classifications for severe bleeding in obstetrics. During pregnancy there are several changes in coagulation state: because haemostatic reference intervals are generally based on samples from non-pregnant women, this can cause a further difficulty in doing an accurate diagnosis and treatment of haemostatic disorders during pregnancy. In the treatment of critical bleeding in trauma patients have been developed some new insights that may be applied, at least partially, in the management of bleeding patients in obstetrics. In recent years it has been developed an approach called “Damage control resuscitation”, which combines to the surgery a medical treatment aimed at correcting the underlying coagulopathy. This approach is based on three items: minimise use of crystalloids and colloids; optimise fresh frozen plasma (FFP) to red blood cells (RBC) ratio; make an appropriate use of antifibrinolitic agents, fibrinogen and cryoprecipitate.
 
Publisher SEEd
 
Contributor
 
Date 2013-09-15
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion


 
Format text/html
application/pdf
 
Identifier https://journals.edizioniseed.it/index.php/rhc/article/view/879
10.7175/rhc.v4i3S.879
 
Source Reviews in Health Care; Vol 4, No 3S (2013); 41-51
2038-6702
2038-6699
 
Language eng
 
Relation https://journals.edizioniseed.it/index.php/rhc/article/view/879/994
https://journals.edizioniseed.it/index.php/rhc/article/view/879/995
 
Coverage


 
Rights Copyright (c) 2013 Seed
http://creativecommons.org/licenses/by-nc/4.0
 

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