NYMC Faculty Publications
Latest Advances in Postpartum Hemorrhage Management
Author Type(s)
Faculty
DOI
10.1016/j.bpa.2022.02.004
Journal Title
Best Practice & Research. Clinical Anaesthesiology
First Page
123
Last Page
134
Document Type
Article
Publication Date
5-1-2022
Department
Anesthesiology
Abstract
Hemorrhage is the leading cause of maternal mortality worldwide. A maternal health priority is improving how healthcare providers prevent and manage postpartum hemorrhage (PPH). Because anesthesiologists can help facilitate how hospitals develop approaches for PPH prevention and anticipatory planning, we review the potential utility of PPH risk-assessment tools, bundles, and protocols. Anesthesiologists rely on clinical and diagnostic information for initiating and evaluating medical management. Therefore, we review modalities for measuring blood loss after delivery, which includes visual, volumetric, gravimetric, and colorimetric approaches. Point-of-care technologies for assessing changes in central hemodynamics (ultrasonography) and coagulation profiles (rotational thromboelastometry and thromboelastography) are also discussed. Anesthesiologists play a critical role in the medical and transfusion management of PPH. Therefore, we review blood ordering and massive transfusion protocols, fixed-ratio vs. goal-directed transfusion approaches, coagulation changes during PPH, and the potential clinical utility of the pharmacological adjuncts, tranexamic acid, and fibrinogen concentrate.
Recommended Citation
Kumaraswami, S., & Butwick, A. (2022). Latest Advances in Postpartum Hemorrhage Management. Best Practice & Research. Clinical Anaesthesiology, 36 (1), 123-134. https://doi.org/10.1016/j.bpa.2022.02.004
