Standardized Management Protocol in Severe Postpartum Hemorrhage: A Single-Center Study.

Colucci, Giuseppe; Helsing, Karin; Biasiutti, Franziska Demarmels; Raio, Luigi; Schmid, Pirmin; Tsakiris, Dimitrios A; Eberle, Balthasar; Surbek, Daniel; Lämmle, Bernhard; Alberio, Lorenzo (2018). Standardized Management Protocol in Severe Postpartum Hemorrhage: A Single-Center Study. Clinical and applied thrombosis, hemostasis, 24(6), pp. 884-893. Sage 10.1177/1076029618758956

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Severe postpartum hemorrhage (sPPH) is an obstetric emergency that needs prompt and effective therapy to reduce the risk of complications. In this study, women who developed sPPH (study cohort, n = 27) were treated according to a standardized management protocol prescribing sequential administration of uterotonic drugs, crystalloids, tranexamic acid, labile blood products, low-dose fibrinogen, and recombinant activated factor VII (rFVIIa). This group was compared to patients treated with different strategies during 2 preceding periods: an in-house guideline regulating the administration of rFVIIa (historical cohort 1, n = 20) and no specific guideline (historical cohort 2, n = 27). The management protocol was used over 33 months. The study cohort had a lower estimated blood loss ( P = .004) and required less red blood cell concentrates ( P = .007), fresh frozen plasma units ( P = .004), and platelet concentrates ( P = .020) compared to historical cohort 1 and historical cohort 2, respectively. The necessity of emergency postpartum hysterectomy was lower in the study group ( P = .012). In conclusion, in patients with sPPH treated with this standardized management protocol, we observed a decreased requirement of labile blood products and lower need to proceed to emergency postpartum hysterectomy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Raio, Luigi; Eberle, Balthasar and Surbek, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1076-0296

Publisher:

Sage

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

23 Jan 2019 15:54

Last Modified:

01 Feb 2019 16:27

Publisher DOI:

10.1177/1076029618758956

PubMed ID:

29669438

Uncontrolled Keywords:

blood coagulation disorders hemostatics hysterectomy postpartum hemorrhage pregnancy complications

BORIS DOI:

10.7892/boris.122613

URI:

https://boris.unibe.ch/id/eprint/122613

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