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- doi: 10.1177/1076029618758956
- issn: 1076-0296
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info:eu-repo/semantics/altIdentifier/doi/10.1177/1076029618758956
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info:eu-repo/semantics/altIdentifier/pmid/29669438
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info:eu-repo/semantics/altIdentifier/eissn/1938-2723
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info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_A175FB4998200
info:eu-repo/semantics/openAccess , CC BY-NC 4.0 , https://creativecommons.org/licenses/by-nc/4.0/
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G. Colucci et al., « Standardized Management Protocol in Severe Postpartum Hemorrhage: A Single-Center Study. », Serveur académique Lausannois, ID : 10.1177/1076029618758956
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Severe postpartum hemorrhage (sPPH) is an obstetric emergency that needs prompt and effective therapy to reduce the risk of complications. In this study, women who developed sPPH (study cohort, n = 27) were treated according to a standardized management protocol prescribing sequential administration of uterotonic drugs, crystalloids, tranexamic acid, labile blood products, low-dose fibrinogen, and recombinant activated factor VII (rFVIIa). This group was compared to patients treated with different strategies during 2 preceding periods: an in-house guideline regulating the administration of rFVIIa (historical cohort 1, n = 20) and no specific guideline (historical cohort 2, n = 27). The management protocol was used over 33 months. The study cohort had a lower estimated blood loss ( P = .004) and required less red blood cell concentrates ( P = .007), fresh frozen plasma units ( P = .004), and platelet concentrates ( P = .020) compared to historical cohort 1 and historical cohort 2, respectively. The necessity of emergency postpartum hysterectomy was lower in the study group ( P = .012). In conclusion, in patients with sPPH treated with this standardized management protocol, we observed a decreased requirement of labile blood products and lower need to proceed to emergency postpartum hysterectomy.