Postpartum hemorrhage assessment and targeted treatment

Best Pract Res Clin Anaesthesiol. 2024 Sep;38(3):221-232. doi: 10.1016/j.bpa.2024.10.004. Epub 2024 Oct 11.

Abstract

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, and mitigating it is a global health priority. In this review, we discuss the measurement, assessment, and treatment of PPH. We review different methods of quantifying blood loss, including gravimetry, calibrated drapes and canisters, and colorimetric techniques. Additionally, we highlight the importance of obstetric-specific massive transfusion protocols, point-of-care coagulation testing, and the role of fibrinogen and tranexamic acid. Lastly, we review placenta accreta spectrum management. Anesthesiologists are critical participants in the management of PPH, ultimately influencing patient outcomes.

Keywords: Blood transfusion; Fibrinogen; Maternal mortality; Placenta accreta; Point-of-care systems; Postpartum hemorrhage; Tranexamic acid.

Publication types

  • Review

MeSH terms

  • Blood Transfusion / methods
  • Female
  • Humans
  • Postpartum Hemorrhage* / diagnosis
  • Postpartum Hemorrhage* / therapy
  • Pregnancy
  • Tranexamic Acid / administration & dosage

Substances

  • Tranexamic Acid