scholarly journals POSTPARTUM HEMORRHAGE AND BLOOD TRANSFUSION IN THE MATERNAL TRANSPORT SYSTEM: QUESTIONNAIRE ON LIFE-THREATENING OBSTETRIC HEMORRHAGE AND BLOOD TRANSFUSION CONDUCTED BY THE KANAGAWA PREFECTURAL JOINT COMMITTEE OF BLOOD TRANSFUSION THERAPY

2016 ◽  
Vol 62 (3) ◽  
pp. 462-469 ◽  
Author(s):  
Hisako Okada ◽  
Hisayo Ogawa ◽  
Fumiaki Yoshiba ◽  
Junichi Terauchi ◽  
Akira Ito ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Transport System ◽  
Postpartum Hemorrhage ◽  
Obstetric Hemorrhage ◽  
Transfusion Therapy ◽  
Life Threatening

Serum Lactate Level as a Predictor for Blood Transfusion in Postpartum Hemorrhage

2021 ◽  
Author(s):  
Surbhi Agrawal ◽  
Maria Smith ◽  
Robert Berg ◽  
Iffath A. Hoskins
Keyword(s):  
Blood Transfusion ◽  
Postpartum Hemorrhage ◽  
Lactate Level ◽  
Serum Lactate ◽  
Normal Serum ◽  
Red Blood Cell Transfusion ◽  
Blood Transfusions ◽  
Serum Lactate Level ◽  
Obstetric Hemorrhage ◽  
Lactate Levels

Objective Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality. At present, there are no reliable clinical or laboratory indicators to identify which patients might require blood transfusions during a PPH. Serum lactate has long been used as an early biomarker of tissue hypoperfusion in trauma settings. The aim of this study is to understand serum lactate's role in the management of obstetric hemorrhage. Study Design A retrospective chart review was performed of women who delivered between 2016 and 2019 at our institution and experienced a PPH. The patients were divided into two groups: those with a normal serum lactate level, defined as ≤2 mmol/L, and those with an abnormal serum lactate level, defined as >2 mmol/L. Need for packed red blood cell transfusion, as part of the resuscitation, was assessed for both groups. Results During the study period, 938 women experienced PPH. Of these, 108 (11.5%) had a normal serum lactate, ≤2 mmol/L, and 830 (88.5%) had an abnormal lactate, >2 mmol/L. Women with elevated lactate levels were more likely to receive a blood transfusion versus those with a normal lactate level (57.0 vs. 46.3%, p = 0.035, respectively). Additionally, the average number of blood transfusions administered was significantly higher in the abnormal lactate group versus in the normal lactate group (1.34 vs. 0.97, respectively, p = 0.004). In a multivariable linear regression model, increasing serum lactate levels were found to be predictive of requiring more than 1 unit of blood (p < 0.001). Conclusion Women with elevated serum lactate levels were more likely to require blood transfusions during a PPH versus those with a normal serum lactate level. Thus, serum lactate levels are useful as an early indicator of requirement for blood transfusion in the management of obstetric hemorrhage. Key Points

POSTPARTUM HEMORRHAGE - PREVENTION AND MANAGEMENT

2017 ◽  
pp. 32-39
Author(s):  
Gia Dinh Nguyen
Keyword(s):  
Low Income ◽  
Postpartum Hemorrhage ◽  
Hypovolemic Shock ◽  
Low Income Countries ◽  
Obstetric Hemorrhage ◽  
Maternal Deaths ◽  
Birth Attendants ◽  
Prediction And Prevention ◽  
Life Threatening ◽  
Life Threatening Event

Most maternal deaths due to postpartum hemorrhage (PPH) occur in low-income countries in settings (both hospital and community) where there are no birth attendants or where birth attendants lack the necessary skills or equipment to prevent and manage PPH and shock. In hospital, obstetricians should try to perform the prediction and prevention of PPH, finding the risk factors for developing PPH and how can they be minimised. The treatment of patients with PPH has two major components: (1) Resuscitation and management of obstetric hemorrhage and, possibly, hypovolemic shock and (2) Indentification and management of the underlying cause(s) of the hemorrhage. Successful management of PPH requires that both components be simultaneously and systematically addressed. PPH is a potential life-threatening event. Right from the start, obstetricians have early opportunities to assess risk, anticipate, prevent, plan in advance of a PPH, and can help to improve patients outcomes Key words: postpartum hemorrhage (PPH)

scholarly journals Blood Transfusion in Obstetric Cases

2020 ◽  
pp. 197-200
Author(s):  
Ali Sungkar ◽  
Raymond Surya
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Massive Transfusion ◽  
Patient Blood Management ◽  
Blood Products ◽  
Blood Management ◽  
Transfusion Therapy ◽  
Massive Transfusion Protocol ◽  
Life Threatening ◽  
Transfusion Protocol

Objective: To discuss about blood loss in an obstetric setting, the role of blood transfusion, and patient blood management.Methods: Literature review.Results: Severe anaemia with hemoglobin level less than 7 g/dL or late gestation (more than 34 weeks) and/ or significant symptoms of anaemia, the recommendation is giving only single unit transfusion followed by clinical reassessment for further transfusion. In postpartum hemorrhage (PPH), massive transfusion protocols are commonly used description as large volume of blood products over a brief period to a patient with uncontrolled or severe hemorrhage, transfusion more than 10 RBC units within 24 hours, transfusion more than 4 RBC units in 1 hour with anticipation of continued need for blood, replacement of more than 50% of total blood volume by blood products within 3 hours. All obstetric units have a clear-cut massive transfusion protocol for the initial management of life-threatening PPH, considering early transfusion therapy with RBCs and FFP.Conclusion: Patient blood management aims to maintain hemoglobin concentration, optimize haemostasis, and minimize blood loss in effort to improve patient outcomes. Massive transfusion protocol in management of life-threatening should depend on each obstetric unit.Keywords: blood transfusion, obstetric cases, patient blood management.   Abstrak Tujuan: Untuk mendiskusikan tentang hilang darah dalam obstetric, peran transfusi darah, dan patient blood management.Metode: Kajian pustaka.Hasil: Anemia berat dengan nilai hemoglobin kurang dari 7 g/dL atau kehamilan lanjut (lebih dari 34 minggu) dan/ atau gejala nyata anemia, rekomendasi ialah memberikan satu unit transfusi diikuti dengan penilainan klinis untuk transfusi lebih lanjut. Pada perdarahan postpartum, protokol transfusi massif umum digambarkan sebagai volume darah yang dibutuhkan jumlah banyak dalam periode singkat, transfusi lebih dari 10 sel darah merah dalam 24 jam atau lebih dari 1 jam, penggantian lebih dari 50% total volume darah dalam 3 jam. Seluruh unit obstetric memiliki protokol transfusi massif yang jelas untuk taalaksana awal perdarahan postpartum dengan mempertimbangkan transfusi awal untuk komponen sel darah merah dan FFP.Kesimpulan: Patient blood management bertujuan untuk menjaga konsentrasi hemoglobin, optimalisasi hemostasis, dan minimalisasi hilang darah untuk meningkatkan luaran pasien. Protokol transfusi masfi dalam tatalaksana yang mengancam nyawa sangat bergantung pada setiap unit obstetrik.Kata kunci: kasus obstetri, patient blood management, transfusi darah  

Comparative evaluation of methods of bleeding prevention in the afterbirth and early postnatal periods (literature review)

10.12737/7345 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Гусева ◽  
E. Guseva
Keyword(s):  
Umbilical Cord ◽  
Postpartum Hemorrhage ◽  
High Efficiency ◽  
Massive Bleeding ◽  
Obstetric Hemorrhage ◽  
First Line ◽  
Main Method ◽  
The Third ◽  
Third Stage ◽  
Life Threatening

According to the WHO, each year about 140,000 women die of postpartum hemorrhage, which occur in 5-15% of births. The most common cause of postpartum hemorrhage remains hypotension uterus. Many methods of prevention of obstetric hemorrhage developed, but not all of them have high efficiency. Massive bleeding, life-threatening women, are observed very often. At the present time, the question of active or waiting tactics of the third stage of labour remains controversial. Active tactics of the third stage of labour is recognized as the main method of prevention of postpartum hemorrhage, and includes the use of oxytocin - drug first-line and second-line drugs – ergometrine and prostaglandins. Also the traction of the umbilical cord with extra pressure on the uterus to the placenta (controlled traction of the umbilical cord) is carried out. In contrast of active tactics, waiting tactics involve independent birth of the placenta. Active tactic of third stage of labour compared with expectant tactics leads to reduced blood loss, but its use increases the risk of side effects. Clear organization for the prevention of postpartum hemorrhage is the real basis of the reduction of maternal mortality and remote serious consequences for the mother.

The Impact of Obesity on the Management and Outcomes of Postpartum Hemorrhage

2020 ◽  
Author(s):  
Aleksandra Polic ◽  
Tierra L. Curry ◽  
Judette M. Louis
Keyword(s):  
Interventional Radiology ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Tertiary Care ◽  
P Value ◽  
Obese Women ◽  
Severe Morbidity ◽  
The Impact ◽  
To Receive

Objective The study aimed to evaluate the impact of obesity on the management and outcomes of postpartum hemorrhage. Study Design We conducted a retrospective cohort study of women who delivered at a tertiary care center between February 1, 2013 and January 31, 2014 and experienced a postpartum hemorrhage. Charts were reviewed for clinical and sociodemographic data, and women were excluded if the medical record was incomplete. Hemorrhage-related severe morbidity indicators included blood transfusion, shock, renal failure, transfusion-related lung injury, cardiac arrest, and use of interventional radiology procedures. Obese (body mass index [BMI] ≥ 30 kg/m2) and nonobese women were compared. Data were analyzed using Chi-square, Student's t-test, Mann–Whitney U test, and linear regression where appropriate. The p-value <0.05 was significant. Results Of 9,890 deliveries, 2.6% (n = 262) were complicated by hemorrhage. Obese women were more likely to deliver by cesarean section (55.5 vs. 39.8%, p = 0.016), undergo a cesarean after labor (31.1 vs. 12.2%, p = 0.001), and have a higher quantitative blood loss (1,313 vs. 1,056 mL, p = 0.003). Both groups were equally likely to receive carboprost, methylergonovine, and misoprostol, but obese women were more likely to receive any uterotonic agent (95.7 vs. 88.9%, p = 0.007) and be moved to the operating room (32.3 vs. 20.4, p = 0.04). There was no difference in the use of intrauterine pressure balloon tamponade, interventional radiology, or decision to proceed with hysterectomy. The two groups were similar in time to stabilization. There was no difference in the need for blood transfusion. Obese women required more units of blood transfused (2.2 ± 2 vs. 2 ± 5 units, p = 0.023), were more likely to have any hemorrhage-related severe morbidity (34.1 vs. 25%, p = 0.016), and more than one hemorrhage related morbidity (17.1 vs. 7.9, p = 0.02). After controlling for confounding variables, quantitative blood loss, and not BMI was predictive of the need for transfusion. Conclusion Despite similar management, obese women were more likely to have severe morbidity and need more units of blood transfused. Key Points

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