Post-partum haemorrhage

Mukherjee, Soma; Arulkumaran, Sabaratnam

doi:10.1016/j.ogrm.2009.01.005

« Previous Next »Obstetrics, Gynaecology and Reproductive Medicine
Volume 19, Issue 5 , Pages 121-126, May 2009

Post-partum haemorrhage

Soma Mukherjee MBBS MRCOG is a Lecturer in the Department of Obstetrics and Gynaecology, St Georges Hospital, University of London, London, UK

Sabaratnam Arulkumaran MBBS MD PhD FRCOG is a Professor at the Department of Obstetrics and Gynaecology, St Georges Hospital, University of London, London, UK

Abstract

Obstetric haemorrhage accounts for 25% of maternal deaths in developing countries and post-partum haemorrhage (PPH) is the most common type. It accounts for 10.6% of all direct maternal deaths in the UK and, according to the recent Confidential Enquiries into Maternal and Child Health report, it is the third most common cause of maternal mortality. The enquiry concluded that a number of these deaths were avoidable and highlighted ‘doing too little too late’.

Failure to assess the clinical picture, underestimating blood loss, delayed treatment, lack of multidisciplinary team work and failure to seek timely senior help are some of the issues highlighted. Clinicians should be aware of appropriate surgical measures and the timing of interventions. Effective team work, pooling of resources and the presence of a ‘rapid PPH response teams’ can improve outcome.

Keywords: balloon tamponade, blood transfusion, haemostasis, postpartum haemorrhage, surgery, uterotonics