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Management of post‐partum haemorrhage
Author(s) -
AHONEN J.,
STEFANOVIC V.,
LASSILA R.
Publication year - 2010
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2010.02309.x
Subject(s) - medicine , uterine atony , arterial embolization , balloon tamponade , surgery , fibrinolysis , embolization , coagulopathy , uterotonic , bleed , hemostasis , tamponade , coagulation , pregnancy , hysterectomy , oxytocin , biology , genetics
Management of post‐partum haemorrhage (PPH) involves the treatment of uterine atony, evacuation of retained placenta or placental fragments, surgery due to uterine or birth canal trauma, balloon tamponade, effective volume replacement and transfusion therapy, and occasionally, selective arterial embolization. This article aims at introducing pregnancy‐ and haemorrhage‐induced changes in coagulation and fibrinolysis and their relevant compensatory mechanisms, volume replacement therapy, optimal transfusion of blood products, and coagulation factor concentrates, and briefly cell salvage, management of uterine atony, surgical interventions, and selective arterial embolization. Special attention, respective management, and follow‐up are required in women with bleeding disorders, such as von Willebrand disease, carriers of haemophilia A or B, and rare coagulation factor deficiencies. We also provide a proposal for practical instructions in the treatment of PPH.