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Current Anesthesiology Reports

, Volume 9, Issue 1, pp 60–68 | Cite as

Update on Obstetric Hemorrhage

  • Sharon C. RealeEmail author
  • Lisa R. Leffert
  • Michaela K. Farber
Obstetric Anesthesia (LR Leffert, Section Editor)
  • 21 Downloads
Part of the following topical collections:
  1. Obstetric Anesthesia

Abstract

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.

Recent Findings

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.

Summary

Continued focus on improving the management of postpartum hemorrhage with available resources is imperative to minimize associated risks of morbidity and mortality.

Keywords

Postpartum hemorrhage Obstetric hemorrhage Maternal morbidity Transfusion medicine Point-of-care testing Quantitative blood loss measurement 

Notes

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.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Sharon C. Reale
    • 1
    Email author
  • Lisa R. Leffert
    • 2
  • Michaela K. Farber
    • 1
  1. 1.Brigham and Women’s Hospital, Department of Anesthesiology, Perioperative and Pain MedicineHarvard Medical SchoolBostonUSA
  2. 2.Massachusetts General Hospital, Department of Anesthesia, Critical Care, and Pain MedicineHarvard Medical SchoolBostonUSA

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