Peripartum life-threatening haemorrhage - 2018


Peripartum life-threatening hemorrhage is defined as quickly increasing blood loss, which is clinically estimated at 1500 ml and more and which is connected with development of clinical and/or laboratory signs of tissue hypoperfusion.

2018
Birth
bleeding
PPH
peripartum
hemorrhage
Published at: 1.6.2018

Review

Pavlína Nosková, MD, PhD
Deputy of Chief Obstetric Anaesthesiologist, Dept. of Anaesthesiology and Intensive Care, 1st Faculty of Medicine, Charles University in Prague; General University Hospital, Prague, Czech Republic Member of Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine

The most frequent cause of maternal morbidity and mortality is postpartum haemorrhage (PPH). A background of PPH is in 70-80 % hypotony or atony of the uterus. This is followed by delivery trauma in 10-15 % and in 1-5 % by placenta adherens or placenta accreta. Disseminated intravascular coagulopathy (DIC) participates in only 1-3 % and mostly it is connected with emboly of foetal water or during abruption of placenta. This practical and well arranged algorithm is led by the anesthesiologist in cooperation with the obstetrician and it leads to a solution of this critical condition in gynecology. The materials are based on the newest czechoslovakian interdisciplinary recommended techniques and guidelines from the year 2018. This brings us to a new and rational view on this problem.
The target of medical effort is to stop PPH and to protect and preserve uterus by using all contemporary accessible methods and medical guidelines.

Sources

Czech Society of Anaesthesiology and Intensive Care Medicine guidelines - update 2017
http://www.csarim.cz/storage/app/media/Doporucene%20postupy%20a%20stanoviska%20CSARIM/PERIPARTALNI_ZIVOT_OHROZUJICI_KRVACENI_MEZIOBOROVE_KONSENSUALNI_STANOVISKO_2011.pdf

SILBERNAGL, Stefan a Agamemnon DESPOPOULOS. Atlas of Human Physiology : 6th edition, completely redesigned and expanded. 3rd edition. Praha : Grada, 2004. ISBN 80-247-0630-X

KITTNAR, Otomar a ET AL.. Medical physiology. 1st edition. Praha : Grada, 2011. 790 s. s. 151. ISBN 978-80-247-3068-4.

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