Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group.
Marian Knight,William M. Callaghan,Cynthia J. Berg,Sophie Alexander,Marie-Hélène Bouvier-Colle,Jane B. Ford,K.S. Joseph,K.S. Joseph,Gwyneth Lewis,Robert Liston,Christine L. Roberts,Jeremy Oats,James J. Walker +12 more
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Clinicians should be more vigilant given the possibility that the frequency and severity of PPH has in fact increased, and training should be provided to all staff involved in maternity care concerning assessment of blood loss and the monitoring of women after childbirth.Abstract:
BACKGROUND: Postpartum hemorrhage (PPH) is a major cause of maternal mortality and morbidity worldwide. Several recent publications have noted an increasing trend in incidence over time. The international PPH collaboration was convened to explore the observed trends and to set out actions to address the factors identified. METHODS: We reviewed available data sources on the incidence of PPH over time in Australia, Belgium, Canada, France, the United Kingdom and the USA. Where information was available, the incidence of PPH was stratified by cause. RESULTS: We observed an increasing trend in PPH, using heterogeneous definitions, in Australia, Canada, the UK and the USA. The observed increase in PPH in Australia, Canada and the USA was limited solely to immediate/atonic PPH. We noted increasing rates of severe adverse outcomes due to hemorrhage in Australia, Canada, the UK and the USA. CONCLUSION: Key Recommendations 1. Future revisions of the International Classification of Diseases should include separate codes for atonic PPH and PPH immediately following childbirth that is due to other causes. Also, additional codes are required for placenta accreta/percreta/increta. 2. Definitions of PPH should be unified; further research is required to investigate how definitions are applied in practice to the coding of data. 3. Additional improvement in the collection of data concerning PPH is required, specifically including a measure of severity. 4. Further research is required to determine whether an increased rate of reported PPH is also observed in other countries, and to further investigate potential risk factors including increased duration of labor, obesity and changes in second and third stage management practice. 5. Training should be provided to all staff involved in maternity care concerning assessment of blood loss and the monitoring of women after childbirth. This is key to reducing the severity of PPH and preventing any adverse outcomes. 6. Clinicians should be more vigilant given the possibility that the frequency and severity of PPH has in fact increased. This applies particularly to small hospitals with relatively few deliveries where management protocols may not be defined adequately and drugs or equipment may not be on hand to deal with unexpected severe PPH.read more
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Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom.
Roch Cantwell,Thomas Clutton-Brock,G. M. Cooper,Andrew J. Dawson,James Owen Drife,Debbie Garrod,Ann Harper,Diana Hulbert,Sebastian Lucas,John D. McClure,Harry Millward-Sadler,James P Neilson,Catherine Nelson-Piercy,Jane E. Norman,Colm O'Herlihy,Margaret R. Oates,Judy Shakespeare,Michael de Swiet,Catherine Williamson,Valerie Beale,Marian Knight,Christopher E. Lennox,Alison Miller,Dharmishta Parmar,Jane Rogers,Anna Springett +25 more
TL;DR: For the first time there has been a reduction in the inequalities gap, with a significant decrease in maternal mortality rates among those living in the most deprived areas and those in the lowest socio-economic group.
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Effect of Prepregnancy Maternal Overweight and Obesity on Pregnancy Outcome
TL;DR: A population-based study on a cohort of all Danish women giving birth to a singleton from 2004 through June 30, 2010 shows a significant increased risk of a wide variety of pregnancy, birth, and neonatal complications in overweight, obese, and severely obese women.
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Treatment for Primary Postpartum Haemorrhage
TL;DR: Rectal misoprostol in a dose of 800 micrograms could be a useful 'first line' drug for the treatment of primary postpartum haemorrhage.
Journal ArticleDOI
Incidence, risk factors, and temporal trends in severe postpartum hemorrhage
Michael S. Kramer,Cynthia J. Berg,Haim A. Abenhaim,Mourad Dahhou,Jocelyn Rouleau,Azar Mehrabadi,K.S. Joseph +6 more
TL;DR: A doubling in incidence of severe PPH over 10 years was not explained by contemporaneous changes in studied risk factors, as well as changes in risk factors themselves.
Iconographies supplémentaires de l'article : Incidence, risk factors, and temporal trends in severe postpartum hemorrhage
Michael S. Kramer,Cynthia J. Berg,Haim A. Abenhaim,Mourad Dahhou,Jocelyn Rouleau,Azar Mehrabadi,K.S. Joseph +6 more
TL;DR: In this paper, the authors examined temporal trends in severe postpartum hemorrhage, defined as PPH plus receipt of a blood transfusion, hysterectomy, and/or surgical repair of the uterus.
References
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