Female ; Humans ; Hysterectomy ; Postpartum Hemorrhage/therapy* ; Postpartum Period ; Risk Assessment ; Treatment Outcome ; Uterine Balloon Tamponade

Postpartum hemorrhage (PPH) is an important cause of maternal mortality. There is currently no single, satisfactory definition of PPH. The various definitions of PPH may result in delayed diagnosis. Underestimated blood loss concerning PPH is considered one of the biggest problems. The diagnosis of PPH should include proper estimation of blood loss before vital signs and clinical symptoms change. Management of PPH involves early recognition, assessment and resuscitation. Careful monitoring of vital signs, laboratory tests, coagulation testing in particular, and timely diagnosis of the cause of PPH are important. The first priority in the management of PPH is the rapid correction of hypovolemia with fluid infusion and packed red blood cells transfusion, followed by blood component therapy as indicated by the hematocrit, coagulation tests, platelet count and clinical features. Pharmacological management of PPH is to contract uterus (e.g., oxytocin, methylergonovine, 15-methylprostaglandin F2alpha, misoprostol) and to aid hemostasis (e.g., tranexamic acid, recombinant factor VIIa). Surgical management (e.g., balloon tamponade, uterine compression suture, iliac artery ligation) should be considered if hemorrhage persists or vital signs is unstable.
Blood Transfusion ; Carboprost ; Delayed Diagnosis ; Diagnosis* ; Erythrocytes ; Hematocrit ; Hemorrhage ; Hemostasis ; Hypovolemia ; Iliac Artery ; Maternal Mortality ; Methylergonovine ; Oxytocin ; Platelet Count ; Postpartum Hemorrhage* ; Postpartum Period* ; Resuscitation ; Sutures ; Tranexamic Acid ; Uterine Balloon Tamponade ; Uterus ; Vital Signs

Postpartum hemorrhage (PPH) is an important cause of maternal mortality. There is currently no single, satisfactory definition of PPH. The various definitions of PPH may result in delayed diagnosis. Underestimated blood loss concerning PPH is considered one of the biggest problems. The diagnosis of PPH should include proper estimation of blood loss before vital signs and clinical symptoms change. Management of PPH involves early recognition, assessment and resuscitation. Careful monitoring of vital signs, laboratory tests, coagulation testing in particular, and timely diagnosis of the cause of PPH are important. The first priority in the management of PPH is the rapid correction of hypovolemia with fluid infusion and packed red blood cells transfusion, followed by blood component therapy as indicated by the hematocrit, coagulation tests, platelet count and clinical features. Pharmacological management of PPH is to contract uterus (e.g., oxytocin, methylergonovine, 15-methylprostaglandin F2alpha, misoprostol) and to aid hemostasis (e.g., tranexamic acid, recombinant factor VIIa). Surgical management (e.g., balloon tamponade, uterine compression suture, iliac artery ligation) should be considered if hemorrhage persists or vital signs is unstable.
Blood Transfusion ; Carboprost ; Delayed Diagnosis ; Diagnosis* ; Erythrocytes ; Hematocrit ; Hemorrhage ; Hemostasis ; Hypovolemia ; Iliac Artery ; Maternal Mortality ; Methylergonovine ; Oxytocin ; Platelet Count ; Postpartum Hemorrhage* ; Postpartum Period* ; Resuscitation ; Sutures ; Tranexamic Acid ; Uterine Balloon Tamponade ; Uterus ; Vital Signs