Korean J Obstet Gynecol.
2005 Dec;48(12):2765-2776.
Recent Trends in the Management of Postpartum Hemorrhage
- Affiliations
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- 1Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. jyshim@amc.seoul.kr
Abstract
- The management of postpartum hemorrhage remains one of the significant challenges to clinical practitioners of obstetrics. Massive postpartum hemorrhage is a major cause of maternal death and morbidity. Early postpartum hemorrhage refers to bleeding within the first 24 hours after delivery; late of delayed postpartum hemorrhage occurs more than 24 hours but less than six weeks after delivery. Uterine atony remains the most common cause with many patients presenting with no known risk factors. Postpartum bleeding can result from uterine atony, genital tract lacerations or hematomas, retained placenta, uterine inversion and acquired or inherited coagulopathies. Every obstetrics unit should have protocols available to deal with hemorrhage and have specific guidelines for patients who object to blood transfusions for various reasons. Placement and utilization of arterial catheters for uterine artery embolization is becoming more widespread. Timely hysterectomy should be performed for signs of refractory bleeding. Application of medical and surgical principles combined with recent new technologic advances will help the obstetrician avoid disastrous outcomes for both mother and fetus.
