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CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(11): 776-784
DOI: 10.1055/s-0040-1721882
DOI: 10.1055/s-0040-1721882
Febrasgo Position Statement
Postpartum hemorrhage: prevention, diagnosis and non-surgical management
Number 5 - November 2020
Key points
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Postpartum hemorrhage is the world's leading cause of maternal death and peripartum hysterectomy.
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The main causes of postpartum hemorrhage are uterine atony, birth canal trauma, retention of placental remains and coagulation disorders.
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Risk stratification for postpartum hemorrhage optimizes care planning and promotes early adoption of preventive measures.
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Bleeding control within the first hour of diagnosis (“golden hour”) is the most effective measure for treating postpartum hemorrhage.
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The shock index is the clinical method of choice for estimating blood loss and a good parameter to guide the need for blood transfusion.
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The main drugs used in pharmacological therapy for postpartum hemorrhage are oxytocin, ergot derivatives, misoprostol and tranexamic acid.
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In uterine atony with pharmacological therapy failure, the intrauterine balloon tamponade should precede the surgical approach.
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The non-pneumatic anti-shock garment is useful in postpartum hemorrhage with hemodynamic instability and enables continuity of treatment and patient transfers.
The National Specialty Commission for Obstetric Emergencies of the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO) endorses to this document. The content production is based on scientific studies on a thematic proposal and the findings presented contribute to clinical practice.
Publikationsverlauf
Artikel online veröffentlicht:
30. November 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
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References
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