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CEU: Prevention and Treatment of Postpartum Hemorrhage: New Advances for Low‐Resource Settings
Author(s) -
Miller Suellen,
Lester Felicia,
Hensleigh Paul
Publication year - 2004
Publication title -
the journal of midwifery and womens health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1016/j.jmwh.2004.04.001
Subject(s) - uterine atony , medicine , uterotonic , misoprostol , intensive care medicine , inflatable , obstetrics , pregnancy , surgery , hysterectomy , oxytocin , abortion , mechanical engineering , biology , engineering , genetics
Postpartum hemorrhage due to uterine atony is the primary direct cause of maternal mortality globally. Management strategies in developed countries involve crystalloid fluid replacement, blood transfusions, and surgery. These definitive therapies are often not accessible in developing countries. Long transports from home or primary health care facilities, a dearth of skilled providers, and lack of intravenous fluids and/or a safe blood supply often create long delays in instituting appropriate treatment. We review the evidence for active management of third‐stage labor and for the use of specific uterotonics. New strategies to prevent and manage postpartum hemorrhage in developing countries, such as community‐based use of misoprostol, oxytocin in the Uniject delivery system, the non‐inflatable antishock garment to stabilize and resuscitate hypovolemic shock, and the balloon condom catheter to treat intractable uterine bleeding are reviewed. New directions for clinical and operations research are suggested.