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) |
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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, 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: |
05 Dec 2022 15:23 |
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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