Update on Obstetric Hemorrhage
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Purpose of Review
Postpartum hemorrhage is increasing in prevalence in the USA and continues to be an important cause of preventable maternal morbidity and mortality. This review provides the most recent epidemiologic data on postpartum hemorrhage in the USA, current nationwide initiatives for prevention, preparedness, and response to postpartum hemorrhage, and recent evidence-based advances in management.
The National Partnership for Maternal Safety consensus bundle on obstetric hemorrhage serves as a resource for postpartum hemorrhage–related clinical and research initiatives. Areas of focus include standardizing postpartum hemorrhage management with protocol use, massive transfusion protocols, early and enhanced risk assessment, accurate quantitation of blood loss, and refined transfusion strategies such as early fibrinogen replacement, tranexamic acid therapy, and point of care testing to detect and treat coagulopathy.
Continued focus on improving the management of postpartum hemorrhage with available resources is imperative to minimize associated risks of morbidity and mortality.
KeywordsPostpartum hemorrhage Obstetric hemorrhage Maternal morbidity Transfusion medicine Point-of-care testing Quantitative blood loss measurement
Compliance with Ethical Standards
Conflict of Interest
Sharon C. Reale, Lisa R. Leffert, and Michaela K. Farber declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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