Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016)

Dietmar Schlembach; Hanns Helmer; Wolfgang Henrich; Christian von Heymann; Franz Kainer; Wolfgang Korte; Maritta Kühnert; Heiko Lier; Holger Maul; Werner Rath; Susanne Steppat; Daniel Surbek; Jürgen Wacker

doi:10.1055/a-0582-0122

Geburtshilfe und Frauenheilkunde, Table of Contents

CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(04): 382-399
DOI: 10.1055/a-0582-0122

GebFra Science

Guideline/Leitlinie

Georg Thieme Verlag KG Stuttgart · New York

Peripartale Blutungen, Diagnose und Therapie. Leitlinie der DGGG, OEGGG und SGGG (S2k-Level, AWMF-Registernummer 015/063, März 2016)

Article in several languages: English | deutsch

Dietmar Schlembach

¹Klinik für Geburtsmedizin, Vivantes Klinikum Neukölln, Berlin, Germany

,

Hanns Helmer

²Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Wien, Austria

,

Wolfgang Henrich

³Klinik für Geburtsmedizin, Charité – Universitätsmedizin Berlin, Berlin, Germany

,

Christian von Heymann

⁴Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, Vivantes Klinikum im Friedrichshain, Berlin, Germany

,

Franz Kainer

⁵Geburtshilfe und Pränatalmedizin, Klinik Hallerwiese, Nürnberg, Germany

,

Wolfgang Korte

⁶Zentrum für Labormedizin, St. Gallen, Switzerland

,

Maritta Kühnert

⁷Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Gießen-Marburg, Marburg, Germany

,

Heiko Lier

⁸Klinik für Anästhesie und operative Intensivmedizin, Universitätsklinik Köln, Köln, Germany

,

Holger Maul

⁹Geburtshilfe & Pränatalmedizin, Asklepios Klinik Barmbek, Hamburg, Germany

,

Werner Rath

¹⁰Gynäkologie und Geburtshilfe, Universitätsklinikum RWTH Aachen, Aachen, Germany

,

Susanne Steppat

¹¹Deutscher Hebammenverband, Karlsruhe, Germany

,

Daniel Surbek

¹²Universitätsklinik für Frauenheilkunde, Geburtshilfe und feto-maternale Medizin, Bern, Switzerland

,

Jürgen Wacker

¹³Klinik für Gynäkologie und Geburtshilfe, Fürst-Stirum-Klinik Bruchsal, Bruchsal, Germany

› Author Affiliations

Abstract

Zusammenfassung

Ziel Erstellung einer offiziellen interdisziplinären Leitlinie, publiziert und koordiniert von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG) und der Schweizerischen Gesellschaft für Gynäkologie und Geburtshilfe (SGGG). Die Leitlinie wurde für den deutschsprachigen Raum entwickelt und wird von der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), der Gesellschaft für Thrombose- und Hämostaseforschung (GTH) und dem Deutschen Hebammenverband mitgetragen. Das Ziel dieser Leitlinie ist es, durch die Evaluation der relevanten Literatur einen konsensbasierten Überblick über die Diagnostik und das Management der peripartalen Blutung zu geben.

Methoden Diese S2k-Leitlinie wurde durch einen strukturierten Konsens von repräsentativen Mitgliedern verschiedener Fachgesellschaften und Professionen im Auftrag der Leitlinienkommission der DGGG entwickelt.

Empfehlungen Es werden Empfehlungen zur Definition, Risikostratifizierung, Prävention und Management gegeben.

Schlüsselwörter

peripartale Blutung - Plazentaimplantationsstörung - Uterusatonie - chirurgische Therapie - medikamentöse Therapie - Embolisation

Full Text

References

References/Literatur
1 Dupont C, Touzet S, Colin C. et al. Incidence and management of postpartum haemorrhage following the dissemination of guidelines in a network of 16 maternity units in France. Int J Obstet Anesth 2009; 18: 320-327
2 Knight M, Callaghan WM, Berg C. et al. Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy Childbirth 2009; 9: 55
3 Bateman BT, Berman MF, Riley LE. et al. The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries. Anesth Analg 2010; 110: 1368-1373
4 Callaghan WM, Kuklina EV, Berg CJ. Trends in postpartum hemorrhage: United States, 1994–2006. Am J Obstet Gynecol 2010; 202: 353.e1-353.e6
5 Kramer MS, Berg C, Abenhaim H. et al. Incidence, risk factors, and temporal trends in severe postpartum hemorrhage. Am J Obstet Gynecol 2013; 209: 449.e1-449.e7
6 Joseph KS, Rouleau J, Kramer MS. et al. Investigation of an increase in postpartum haemorrhage in Canada. BJOG 2007; 114: 751-759
7 Samangaya R, Pennington R, Vause S. Factors relating to a rising incidence of major postpartum haemorrhage. BJOG 2010; 117: 370 author reply 370–371
8 Kramer MS, Dahhou M, Vallerand D. et al. Risk factors for postpartum hemorrhage: can we explain the recent temporal increase?. J Obstet Gynaecol Can 2011; 33: 810-819
9 Buchanan SL, Patterson JA, Roberts CL. et al. Trends and morbidity associated with oxytocin use in labour in nulliparas at term. Aust N Z J Obstet Gynaecol 2012; 52: 173-178
10 Liu S, Joseph KS, Hutcheon JA. et al. Gestational age-specific severe maternal morbidity associated with labor induction. Am J Obstet Gynecol 2013; 209: 209.e1-209.e8
11 Mehrabadi A, Hutcheon JA, Lee L. et al. Epidemiological investigation of a temporal increase in atonic postpartum haemorrhage: a population-based retrospective cohort study. BJOG 2013; 120: 853-862
12 Mousa HA, Walkinshaw S. Major postpartum haemorrhage. Curr Opin Obstet Gynecol 2001; 13: 595-603
13 Waterstone M, Bewley S, Wolfe C. Incidence and predictors of severe obstetric morbidity: case-control study. BMJ 2001; 322: 1089-1093 discussion 1093–1084
14 AbouZahr C. Global burden of maternal death and disability. Br Med Bull 2003; 67: 1-11
15 Hogberg U. The World Health Report 2005: “make every mother and child count” – including Africans. Scand J Public Health 2005; 33: 409-411
16 American College of Obstetricians and Gynecologists. ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol 2006; 108: 1039-1047
17 Khan KS, Wojdyla D, Say L. et al. WHO analysis of causes of maternal death: a systematic review. Lancet 2006; 367: 1066-1074
18 Roberts CL, Ford JB, Algert CS. et al. Trends in adverse maternal outcomes during childbirth: a population-based study of severe maternal morbidity. BMC Pregnancy Childbirth 2009; 9: 7
19 Ronsmans C, Graham WJ. Lancet Maternal Survival Series steering group. Maternal mortality: who, when, where, and why. Lancet 2006; 368: 1189-1200
20 Cantwell R, Clutton-Brock T, Cooper G. et al. Saving mothersʼ lives: reviewing maternal deaths to make motherhood safer: 2006–2008. The eighth report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG 2011; 118 (Suppl. 01) 1-203
21 Haeri S, Dildy 3rd GA. Maternal mortality from hemorrhage. Semin Perinatol 2012; 36: 48-55
22 Grobman WA, Bailit JL, Rice MM. et al. Frequency of and factors associated with severe maternal morbidity. Obstet Gynecol 2014; 123: 804-810
23 Arulkuman S, Mavrides E, Penney GC. RCOG Green-top Guideline No. 52: Prevention and management of postpartum haemorrhage. 2011 Online: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg52/ last access: 04.04.2018
24 Farquhar C, Sadler L, Masson V. et al. Beyond the numbers: classifying contributory factors and potentially avoidable maternal deaths in New Zealand, 2006–2009. Am J Obstet Gynecol 2011; 205: 331.e1-331.e8
25 Saucedo M, Deneux-Tharaux C, Bouvier-Colle MH. French National Experts Committee on Maternal Mortality. Ten years of confidential inquiries into maternal deaths in France, 1998–2007. Obstet Gynecol 2013; 122: 752-760
26 Duthie SJ, Ven D, Yung GL. et al. Discrepancy between laboratory determination and visual estimation of blood loss during normal delivery. Eur J Obstet Gynecol Reprod Biol 1991; 38: 119-124
27 Descargues G, Pitette P, Gravier A. et al. [Missed diagnosis of postpartum hemorrhage]. J Gynecol Obstet Biol Reprod (Paris) 2001; 30: 590-600
28 Bose P, Regan F, Paterson-Brown S. Improving the accuracy of estimated blood loss at obstetric haemorrhage using clinical reconstructions. BJOG 2006; 113: 919-924
29 Rath W, Schneider M. Definitionen und Diagnostik postpartaler Blutungen (PPH): Unterschätzte Probleme! [Definitions and Diagnosis of Postpartum Haemorrhage (PPH): Underestimated Problems!]. Geburtsh Frauenheilk 2010; 70: 36-40
30 Alexander J, Thomas P, Sanghera J. Treatments for secondary postpartum haemorrhage. Cochrane Database Syst Rev 2002; (01) CD002867
31 Rizvi F, Mackey R, Barrett T. et al. Successful reduction of massive postpartum haemorrhage by use of guidelines and staff education. BJOG 2004; 111: 495-498
32 Obstetrical hemorrhage. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. eds. Williams Obstetrics. 23rd ed.. New York: McGraw-Hill; 2010: 757-803
33 Upadhyay K, Scholefield H. Risk management and medicolegal issues related to postpartum haemorrhage. Best Pract Res Clin Obstet Gynaecol 2008; 22: 1149-1169
34 Driessen M, Bouvier-Colle MH, Dupont C. et al. Postpartum hemorrhage resulting from uterine atony after vaginal delivery: factors associated with severity. Obstet Gynecol 2011; 117: 21-31
35 Main EK, Goffman D, Scavone BM. et al. National partnership for maternal safety: consensus bundle on obstetric hemorrhage. Obstet Gynecol 2015; 126: 155-162
36 Merz E, Eichhorn KH, von Kaisenberg C. et al. Arbeitsgruppe der DEGUM-Stufe III. [Updated quality requirements regarding secondary differentiated ultrasound examination in prenatal diagnostics (= DEGUM level II) in the period from 18 + 0 to 21 + 6 weeks of gestation]. Ultraschall Med 2012; 33: 593-596
37 Al-Zirqi I, Vangen S, Forsen L. et al. Prevalence and risk factors of severe obstetric haemorrhage. BJOG 2008; 115: 1265-1272
38 Sosa CG, Althabe F, Belizan JM. et al. Risk factors for postpartum hemorrhage in vaginal deliveries in a Latin-American population. Obstet Gynecol 2009; 113: 1313-1319
39 Abdul-Kadir R, McLintock C, Ducloy AS. et al. Evaluation and management of postpartum hemorrhage: consensus from an international expert panel. Transfusion 2014; 54: 1756-1768
40 Rajan PV, Wing DA. Postpartum hemorrhage: evidence-based medical interventions for prevention and treatment. Clin Obstet Gynecol 2010; 53: 165-181
41 Comstock CH. Antenatal diagnosis of placenta accreta: a review. Ultrasound Obstet Gynecol 2005; 26: 89-96
42 Comstock CH, Bronsteen RA. The antenatal diagnosis of placenta accreta. BJOG 2014; 121: 171-181 discussion 181–172
43 Chalubinski KM, Pils S, Klein K. et al. Prenatal sonography can predict degree of placental invasion. Ultrasound Obstet Gynecol 2013; 42: 518-524
44 Kluckow M, Hooper SB. Using physiology to guide time to cord clamping. Semin Fetal Neonatal Med 2015; 20: 225-231
45 Rath W, Bohlmann MK. Postpartale Hämorrhagie – Prävention und Therapie. Gynäkologe 2011; 44: 538-548
46 Kozek-Langenecker SA, Afshari A, Albaladejo P. et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol 2013; 30: 270-382
47 von Heymann C, Kaufner L, Korber M. [Perioperative management and therapy of bleeding complications]. Anasthesiol Intensivmed Notfallmed Schmerzther 2014; 49: 196-204 quiz 205
48 Montufar-Rueda C, Rodriguez L, Jarquin JD. et al. Severe postpartum hemorrhage from uterine atony: a multicentric study. J Pregnancy 2013; 2013: 525914
49 Rath W. [Postpartum Haemorrhage (PPH): “too little is done too late”!]. Z Geburtshilfe Neonatol 2011; 215: 177-181
50 Teixidor Vinas M, Chandraharan E, Moneta MV. et al. The role of interventional radiology in reducing haemorrhage and hysterectomy following caesarean section for morbidly adherent placenta. Clin Radiol 2014; 69: e345-e351
51 Teixidor Vinas M, Belli AM, Arulkumaran S. et al. Prevention of postpartum hemorrhage and hysterectomy in patients with morbidly adherent placenta: a cohort study comparing outcomes before and after introduction of the Triple-P procedure. Ultrasound Obstet Gynecol 2015; 46: 350-355
52 Fuchs I, Dudenhausen JW, Sehouli J. et al. Placenta pathology: disorders of placental location, placental implantation and cord insertion. Ultraschall Med 2008; 29: 4-17 quiz 18–23
53 You WB, Zahn CM. Postpartum hemorrhage: abnormally adherent placenta, uterine inversion, and puerperal hematomas. Clin Obstet Gynecol 2006; 49: 184-197
54 Witteveen T, van Stralen G, Zwart J. et al. Puerperal uterine inversion in the Netherlands: a nationwide cohort study. Acta Obstet Gynecol Scand 2013; 92: 334-337
55 Kenyon S, Tokumasu H, Dowswell T. et al. High-dose versus low-dose oxytocin for augmentation of delayed labour. Cochrane Database Syst Rev 2013; (07) CD007201
56 Langer B, Boudier E, Haberstich R. et al. Collège National des Gynécologues et Obstétriciens Français; Agence Nationale dʼAccréditation et dʼEvaluation en Santé. [Obstetrical management in the event of persistent or worsening postpartum hemorrhage despite initial measures]. J Gynecol Obstet Biol Reprod (Paris) 2004; 33 (8 Suppl.): 4S73-4S79
57 Surbek DV, Fehr PM, Hosli I. et al. Oral misoprostol for third stage of labor: a randomized placebo-controlled trial. Obstet Gynecol 1999; 94: 255-258
58 Hofmeyr GJ, Walraven G, Gulmezoglu AM. et al. Misoprostol to treat postpartum haemorrhage: a systematic review. BJOG 2005; 112: 547-553
59 Langenbach C. Misoprostol in preventing postpartum hemorrhage: a meta-analysis. Int J Gynaecol Obstet 2006; 92: 10-18
60 Lapaire O, Schneider MC, Stotz M. et al. Oral misoprostol vs. intravenous oxytocin in reducing blood loss after emergency cesarean delivery. Int J Gynaecol Obstet 2006; 95: 2-7
61 Mousa HA, Blum J, Abou El Senoun G. et al. Treatment for primary postpartum haemorrhage. Cochrane Database Syst Rev 2014; (02) CD003249
62 Schlembach D, Moertl MG, Girard T. et al. Management der postpartalen Blutung. Der D-A-CH-Algorithmus. Frauenarzt 2013; 54: 1072-1080
63 Kaufner L, Schuster M, Vogt M. et al. [Case report: recurrent postpartum haemorrhage after emergency caesarean section – clipping, embolization and haemostaseological therapy]. Anasthesiol Intensivmed Notfallmed Schmerzther 2012; 47: 308-314
64 Gronvall M, Tikkanen M, Tallberg E. et al. Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: a series of 50 cases from a tertiary teaching hospital. Acta Obstet Gynecol Scand 2013; 92: 433-438
65 Chan LL, Lo TK, Lau WL. et al. Use of second-line therapies for management of massive primary postpartum hemorrhage. Int J Gynaecol Obstet 2013; 122: 238-243
66 Ibrahim M, Ziegler C, Klam SL. et al. Incidence, indications, and predictors of adverse outcomes of postpartum hysterectomies: 20-year experience in a tertiary care centre. J Obstet Gynaecol Can 2014; 36: 14-20
67 Dabelea V, Schultze PM, McDuffie jr. RS. Intrauterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol 2007; 24: 359-364
68 Patacchiola F, DʼAlfonso A, Di Fonso A. et al. Intrauterine balloon tamponade as management of postpartum haemorrhage and prevention of haemorrhage related to low-lying placenta. Clin Exp Obstet Gynecol 2012; 39: 498-499
69 Aibar L, Aguilar MT, Puertas A. et al. Bakri balloon for the management of postpartum hemorrhage. Acta Obstet Gynecol Scand 2013; 92: 465-467
70 Florian A, Carles G, Dallah F. et al. [Value of the Linton-Nachlas balloon for the management of post-partum hemorrhage: a series of 25 cases]. J Gynecol Obstet Biol Reprod (Paris) 2013; 42: 493-498
71 Nelson BD, Stoklosa H, Ahn R. et al. Use of uterine balloon tamponade for control of postpartum hemorrhage by community-based health providers in South Sudan. Int J Gynaecol Obstet 2013; 122: 27-32
72 Tindell K, Garfinkel R, Abu-Haydar E. et al. Uterine balloon tamponade for the treatment of postpartum haemorrhage in resource-poor settings: a systematic review. BJOG 2013; 120: 5-14
73 Morel O, Perdriolle-Galet E, Mezan de Malartic C. et al. [Management of severe or persistent postpartum hemorrhage after vaginal delivery.]. J Gynecol Obstet Biol Reprod (Paris) 2014; 43: 1019-1029
74 Schmid BC, Rezniczek GA, Rolf N. et al. Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage. Am J Obstet Gynecol 2013; 209: 225.e1-225.e5
75 Diemert A, Ortmeyer G, Hollwitz B. et al. The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage. Am J Obstet Gynecol 2012; 206: 65.e1-65.e4
76 Nelson WL, OʼBrien JM. The uterine sandwich for persistent uterine atony: combining the B-Lynch compression suture and an intrauterine Bakri balloon. Am J Obstet Gynecol 2007; 196: e9-e10
77 Merrick K, Jibodu OA, Rajesh U. The difficult PPH: experience of combined use of B-Lynch brace suture and intrauterine Bakri balloon in York hospital, UK. J Obstet Gynaecol 2013; 33: 314-315
78 Cekmez Y, Ozkaya E, Ocal FD. et al. Experience with different techniques for the management of postpartum hemorrhage due to uterine atony: compression sutures, artery ligation and Bakri balloon. Ir J Med Sci 2015; 184: 399-402
79 Deux JF, Bazot M, Le Blanche AF. et al. Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage?. AJR Am J Roentgenol 2001; 177: 145-149
80 Rath W, Hackethal A, Bohlmann MK. Second-line treatment of postpartum haemorrhage (PPH). Arch Gynecol Obstet 2012; 286: 549-561
81 Sentilhes L, Gromez A, Razzouk K. et al. B-Lynch suture for massive persistent postpartum hemorrhage following stepwise uterine devascularization. Acta Obstet Gynecol Scand 2008; 87: 1020-1026
82 Sentilhes L, Trichot C, Resch B. et al. Fertility and pregnancy outcomes following uterine devascularization for severe postpartum haemorrhage. Hum Reprod 2008; 23: 1087-1092
83 Gaia G, Chabrot P, Cassagnes L. et al. Menses recovery and fertility after artery embolization for PPH: a single-center retrospective observational study. Eur Radiol 2009; 19: 481-487
84 Sentilhes L, Gromez A, Trichot C. et al. Fertility after B-Lynch suture and stepwise uterine devascularization. Fertil Steril 2009; 91: 934.e5-934.e9
85 Hollatz-Galuscki E, Michaelis S, Rauber S. et al. Uteruskompressionsnähte – Welche Nahttechnik ist wann indiziert?. Geburtsh Frauenheilk 2013; 73: P70
86 OʼLeary JA. Uterine artery ligation in the control of postcesarean hemorrhage. J Reprod Med 1995; 40: 189-193
87 AbdRabbo SA. Stepwise uterine devascularization: a novel technique for management of uncontrolled postpartum hemorrhage with preservation of the uterus. Am J Obstet Gynecol 1994; 171: 694-700
88 Morel O, Malartic C, Muhlstein J. et al. Pelvic arterial ligations for severe post-partum hemorrhage. Indications and techniques. J Visc Surg 2011; 148: e95-e102
89 Ahonen J, Stefanovic V, Lassila R. Management of post-partum haemorrhage. Acta Anaesthesiol Scand 2010; 54: 1164-1178
90 Rossi AC, Lee RH, Chmait RH. Emergency postpartum hysterectomy for uncontrolled postpartum bleeding: a systematic review. Obstet Gynecol 2010; 115: 637-644
91 Riley DP, Burgess RW. External abdominal aortic compression: a study of a resuscitation manoeuvre for postpartum haemorrhage. Anaesth Intensive Care 1994; 22: 571-575
92 Keogh J, Tsokos N. Aortic compression in massive postpartum haemorrhage–an old but lifesaving technique. Aust N Z J Obstet Gynaecol 1997; 37: 237-238
93 Bloom AI, Verstandig A, Gielchinsky Y. et al. Arterial embolisation for persistent primary postpartum haemorrhage: before or after hysterectomy?. BJOG 2004; 111: 880-884
94 McLintock C, James AH. Obstetric hemorrhage. J Thromb Haemost 2011; 9: 1441-1451
95 Lier H, Rath W. Aktuelle interdisziplinäre Handlungsempfehlungen bei schweren peri-(post-)partalen Blutungen (PPH). [Current Interdisciplinary Recommendations for the Management of Severe Postpartum Hemorrhage (PPH)]. Geburtsh Frauenheilk 2011; 71: 577-588
96 Schols SE, Feijge MA, Lance MD. et al. Effects of plasma dilution on tissue-factor-induced thrombin generation and thromboelastography: partly compensating role of platelets. Transfusion 2008; 48: 2384-2394
97 Tanaka KA, Key NS, Levy JH. Blood coagulation: hemostasis and thrombin regulation. Anesth Analg 2009; 108: 1433-1446
98 Shields LE, Smalarz K, Reffigee L. et al. Comprehensive maternal hemorrhage protocols improve patient safety and reduce utilization of blood products. Am J Obstet Gynecol 2011; 205: 368.e1-368.e8
99 Mellin-Olsen J, Staender S, Whitaker DK. et al. The Helsinki declaration on patient safety in anaesthesiology. Eur J Anaesthesiol 2010; 27: 592-597
100 Grottke O, Frietsch T, Maas M. et al. Umgang mit Massivblutungen und assoziierten perioperativen Gerinnungsstörungen. [Dealing with massive bleeding and associated perioperative coagulopathy: recommendations for action of the German Society of Anaesthesiology and Intensive Care Medicine]. Anaesthesist 2013; 62: 213-224
101 Einerson BD, Miller ES, Grobman WA. Does a postpartum hemorrhage patient safety program result in sustained changes in management and outcomes?. Am J Obstet Gynecol 2015; 212: 140-144.e1
102 Yang H, Zheng S, Shi C. [Clinical study on the efficacy of tranexamic acid in reducing postpartum blood lose: a randomized, comparative, multicenter trial]. Zhonghua Fu Chan Ke Za Zhi 2001; 36: 590-592
103 Gai MY, Wu LF, Su QF. et al. Clinical observation of blood loss reduced by tranexamic acid during and after caesarian section: a multi-center, randomized trial. Eur J Obstet Gynecol Reprod Biol 2004; 112: 154-157
104 Gohel M, Patel P, Gupta A. et al. Efficacy of tranexamic acid in decreasing blood loss during and after cesarean section: a randomized case controlled prospective study. J Obstet Gynecol India 2007; 57: 227-230
105 Sekhavat L, Tabatabaii A, Dalili M. et al. Efficacy of tranexamic acid in reducing blood loss after cesarean section. J Matern Fetal Neonatal Med 2009; 22: 72-75
106 Ducloy-Bouthors AS, Jude B, Duhamel A. et al. High-dose tranexamic acid reduces blood loss in postpartum haemorrhage. Crit Care 2011; 15: R117
107 Gungorduk K, Yildirim G, Asicioglu O. et al. Efficacy of intravenous tranexamic acid in reducing blood loss after elective cesarean section: a prospective, randomized, double-blind, placebo-controlled study. Am J Perinatol 2011; 28: 233-240
108 Movafegh A, Eslamian L, Dorabadi A. Effect of intravenous tranexamic acid administration on blood loss during and after cesarean delivery. Int J Gynaecol Obstet 2011; 115: 224-226
109 Senturk MB, Cakmak Y, Yildiz G. et al. Tranexamic acid for cesarean section: a double-blind, placebo-controlled, randomized clinical trial. Arch Gynecol Obstet 2013; 287: 641-645
110 Novikova N, Hofmeyr GJ, Cluver C. Tranexamic acid for preventing postpartum haemorrhage. Cochrane Database Syst Rev 2015; (06) CD007872
111 Karanth L, Barua A, Kanagasabai S. et al. Desmopressin acetate (DDAVP) for preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. Cochrane Database Syst Rev 2013; (04) CD009824
112 Trigg DE, Stergiotou I, Peitsidis P. et al. A systematic review: the use of desmopressin for treatment and prophylaxis of bleeding disorders in pregnancy. Haemophilia 2012; 18: 25-33
113 Ahonen J. The role of recombinant activated factor VII in obstetric hemorrhage. Curr Opin Anaesthesiol 2012; 25: 309-314
114 Gawron LM, Goldman KN, Kiley J. A gravid development: should the desire to maintain fertility determine treatment for profuse bleeding in pregnancy?. Am J Obstet Gynecol 2013; 208: 332.e1-332.e2
115 Jan JY, Lin SY, Lin CH. et al. Recombinant activated factor VII as a promising adjuvant therapy for postpartum hemorrhage in the practice of obstetric anesthesia: experience from a university hospital in Taiwan. J Obstet Gynaecol Res 2011; 37: 901-907
116 Mercier FJ, Bonnet MP. Use of clotting factors and other prohemostatic drugs for obstetric hemorrhage. Curr Opin Anaesthesiol 2010; 23: 310-316
117 Lavigne-Lissalde G, Aya AG, Mercier FJ. et al. Recombinant human FVIIa for reducing the need for invasive second-line therapies in severe refractory postpartum hemorrhage: a multicenter, randomized, open controlled trial. J Thromb Haemost 2015; 13: 520-529
118 Kevane B, Donnelly J, DʼAlton M. et al. Risk factors for pregnancy-associated venous thromboembolism: a review. J Perinat Med 2014; 42: 417-425
119 Karlsson O, Sporrong T, Hillarp A. et al. Prospective longitudinal study of thromboelastography and standard hemostatic laboratory tests in healthy women during normal pregnancy. Anesth Analg 2012; 115: 890-898
120 Szecsi PB, Jorgensen M, Klajnbard A. et al. Haemostatic reference intervals in pregnancy. Thromb Haemost 2010; 103: 718-727
121 James AH, Konkle BA, Bauer KA. Prevention and treatment of venous thromboembolism in pregnancy in patients with hereditary antithrombin deficiency. Int J Womens Health 2013; 5: 233-241
122 Karpati PC, Rossignol M, Pirot M. et al. High incidence of myocardial ischemia during postpartum hemorrhage. Anesthesiology 2004; 100: 30-36 discussion 35A
123 Heyer L, Mebazaa A, Gayat E. et al. Cardiac troponin and skeletal muscle oxygenation in severe post-partum haemorrhage. Crit Care 2009; 13 (Suppl. 05) S8
124 Rossen J, Okland I, Nilsen OB. et al. Is there an increase of postpartum hemorrhage, and is severe hemorrhage associated with more frequent use of obstetric interventions?. Acta Obstet Gynecol Scand 2010; 89: 1248-1255
125 Gallos G, Redai I, Smiley RM. The role of the anesthesiologist in management of obstetric hemorrhage. Semin Perinatol 2009; 33: 116-123
126 Kuczkowski KM. Anesthesia for the repeat cesarean section in the parturient with abnormal placentation: what does an obstetrician need to know?. Arch Gynecol Obstet 2006; 273: 319-321
127 Fuller AJ, Bucklin BA. Blood product replacement for postpartum hemorrhage. Clin Obstet Gynecol 2010; 53: 196-208
128 Bonnet MP, Deneux-Tharaux C, Bouvier-Colle MH. Critical care and transfusion management in maternal deaths from postpartum haemorrhage. Eur J Obstet Gynecol Reprod Biol 2011; 158: 183-188
129 Rainaldi MP, Tazzari PL, Scagliarini G. et al. Blood salvage during caesarean section. Br J Anaesth 1998; 80: 195-198
130 Goucher H, Wong CA, Patel SK. et al. Cell salvage in obstetrics. Anesth Analg 2015; 121: 465-468
131 Catling S, Haynes SL. Coagulopathy during intraoperative cell salvage in a patient with major obstetric haemorrhage. Br J Anaesth 2011; 106: 749 author reply 750
132 Waldron S. Hypotension associated with leucocyte depletion filters following cell salvage in obstetrics. Anaesthesia 2011; 66: 133-134
133 Pacheco LD, Saade GR, Gei AF. et al. Cutting-edge advances in the medical management of obstetrical hemorrhage. Am J Obstet Gynecol 2011; 205: 526-532
134 Spahn DR, Bouillon B, Cerny V. et al. Management of bleeding and coagulopathy following major trauma: an updated European guideline. Crit Care 2013; 17: R76
135 Cotton BA, Jerome R, Collier BR. et al. Guidelines for prehospital fluid resuscitation in the injured patient. J Trauma 2009; 67: 389-402
136 Stürmer KM, Neugebauer E, Waydhas C. et al. S3-Leitlinie Polytrauma/Schwerverletzten-Behandlung. AWMF 012/019 – S3-Leitlinie. 2011 Online: https://www.dggg.de/fileadmin/documents/leitlinien/archiviert/federfuehrend/012019_Polytrauma_und_Schwerverletzten-Behandlung/012019_2011.pdf last access: 04.04.2018
137 Morrison CA, Carrick MM, Norman MA. et al. Hypotensive resuscitation strategy reduces transfusion requirements and severe postoperative coagulopathy in trauma patients with hemorrhagic shock: preliminary results of a randomized controlled trial. J Trauma 2011; 70: 652-663
138 Napolitano LM, Kurek S, Luchette FA. et al. Clinical practice guideline: red blood cell transfusion in adult trauma and critical care. J Trauma 2009; 67: 1439-1442
139 de Lange NM, van Rheenen-Flach LE, Lance MD. et al. Peri-partum reference ranges for ROTEM(R) thromboelastometry. Br J Anaesth 2014; 112: 852-859
140 Karlsson O, Jeppsson A, Hellgren M. Major obstetric haemorrhage: monitoring with thromboelastography, laboratory analyses or both?. Int J Obstet Anesth 2014; 23: 10-17
141 McNamara H, Mallaiah S, Barclay P. et al. Coagulopathy and placental abruption: changing management with ROTEM-guided fibrinogen concentrate therapy. Int J Obstet Anesth 2015; 24: 174-179
142 Wilson AK, Martel MJ, Arsenault MY. et al. Maternal transport policy. J Obstet Gynaecol Can 2005; 27: 956-963
143 Quinn KH, Mackey A, Cohen J. et al. A curriculum to teach and evaluate resident skills in the management of postpartum hemorrhage. J Perinat Med 2012; 40: 635-639