Unit:
Κατεύθυνση Παθολογία της ΚύησηςLibrary of the School of Health Sciences
Supervisors info:
Καθηγητης Εμ.Σαλαμαλεκης
Original Title:
Αντιμετώπιση αιμορραγίας σε κύηση υψηλού κινδύνου
Summary:
PPH remains a major cause of maternal morbidity and mortality worldwide, but is
difficult to predict due to the diversity of causal factors.
New concepts involving the pathophysiology of hemorrhage have been described
and include early activation of the protein C and fibrinolytic pathways.
Early recognition of obstetric hemorrhage plays a crucial role for prognosis.
Uterotonic therapy must be aggressive, accordance with mother’s medical
history. Surgical management with uterus massage, tamponade and maybe
hysterectomy must be done as early as indicated in order to avoid further blood
loss. Embolization of uterine arteries method maybe an alternative
resuscitation method. New tendencies in hemorrhage treatment include the use of
hemostatic resuscitation. Massive transfusion protocols involve the early
utilization of blood products, early utilization of concentrated coagulation
factors and limit the traditional approach of early massive crystalloid based
resuscitation.
Current approaches to PPH management are hampered by limitations of laboratory
coagulation assessment, poor familiarity with point of- care-based monitoring,
and our limited understanding of the complex coagulopathies that underlie PPH.
Obstetric hemorrhage may be crucial for mother’s life. An organized protocol
for the management of massive obstetric hemorrhage and a rapid co-operation
between anesthesiologist, obstetrician, blood bank and all the staff in the OR
or labor room is needed for the optimal outcome. The keys signs are: early
recognition from the medical staff in labor room or in operation room and early
management of bleeding in order to save mother’s life and maybe mother’s uterus
and subsequently to avoid all adverse effects of massive hemorrhage.
Keywords:
Postpartum hemorrhage , Operation management of bleeding
Number of references:
165
File:
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document.pdf
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