Medical advances in the treatment of postpartum hemorrhage.

Anesth Analg

From the *Pole d'Anesthésie-Réanimation, Academic Hospital Lille, Lille, France; †Pole d'Hématologie Transfusion, Academic Hospital Lille, Lille, France; ‡Université Lille Nord de France, Lille, France; §Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ∥Department of Anesthesia, Stanford University School of Medicine, Stanford, California; and ¶Duke Transfusion Service, Department of Pathology, DUMC, Durham, North Carolina.

Published: November 2014

Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide. Recent advances in the management of severe bleeding for trauma patients may provide insight into PPH management, but must be applied with caution considering the significant differences between trauma and obstetric patients. In this review, we summarized evidence for current management strategies for patients with major obstetric hemorrhage, including (1) rapid laboratory assessment of coagulopathy, (2) early transfusion of plasma and high plasma-to-red blood cell transfusion ratios in massive PPH, and (3) use of tranexamic acid and fibrinogen concentrates in the setting of PPH complicated by coagulopathy.

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Source
http://dx.doi.org/10.1213/ANE.0000000000000450DOI Listing

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