Postpartum hemorrhage is a common and potentially life-threatening obstetric complication, with successful management relying heavily on early identification of hemorrhage and prompt intervention. This article will review the management of postpartum hemorrhage, including initial steps, exam-specific interventions, medical therapy, minimally invasive, and surgical interventions.
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http://dx.doi.org/10.1097/GRF.0000000000000785 | DOI Listing |
JAMA Netw Open
January 2025
Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland.
Importance: Characterizing hospital-level factors associated with adverse outcomes following operative vaginal delivery (OVD) is crucial for optimizing obstetric care.
Objective: To assess the association between hospital OVD volume and adverse outcomes.
Design, Setting, And Participants: This was a retrospective cohort study of OVDs in California between 2008 and 2020.
Can J Anaesth
January 2025
Department of Anesthesia and Pain Management, Mount Sinai Hospital, Mount Sinai Toronto, ON, Canada.
Purpose: Class III obesity (body mass index [BMI] ≥ 40 kg·m) is associated with high rates of Cesarean deliveries and postpartum hemorrhage, with increased maternal and fetal morbidity. The doses of oxytocin and carbetocin are two to four times higher at Cesarean delivery in patients with class III obesity. We sought to investigate the efficacy of carbetocin 80 µg iv compared with oxytocin 1 IU iv (plus infusion) at elective Cesarean delivery in parturients with class III obesity.
View Article and Find Full Text PDFHemasphere
January 2025
Department of Pediatric Hematology and Oncology Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam Rotterdam The Netherlands.
Limited data are available on VWF activity (VWF:Act) and factor VIII (FVIII:C) levels during delivery after VWF/FVIII concentrate administration in women with von Willebrand disease (VWD). We aimed to evaluate treatment with a specific VWF/FVIII concentrate on factor levels in women with VWD during delivery and the postpartum period. A retrospective single-center study was conducted between January 1, 2008, and August 1, 2022.
View Article and Find Full Text PDFCureus
January 2025
Obstetrics and Gynaecology, University of Leeds, Leeds, GBR.
Introduction: Simulation-based learning is a critical component in medical education, particularly for high-risk scenarios like obstetric emergencies. This study utilized Gagné's nine-step instructional model to design and evaluate a clinical simulation session on postpartum hemorrhage (PPH) management for fourth-year medical students.
Methods: The session was structured using Gagné's instructional events, including engaging case vignettes, multimedia presentations, guided practical activities, and immediate feedback.
Am J Obstet Gynecol MFM
January 2025
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205; Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 550 North Broadway Baltimore, MD 21205.
Background: Obstetric hemorrhage is the leading cause of maternal mortality and severe maternal morbidity (SMM) in Maryland and nationally. Currently, through a quality collaborative, the state is implementing the Alliance for Innovation on Maternal Health (AIM) patient safety bundle on obstetric hemorrhage.
Objective: To describe SMM events contributed by obstetric hemorrhage and their preventability in Maryland.
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