Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study
Objective. Postpartum hemorrhage (PPH) is an important cause of maternal mortality (MM) around the world. Seventy percent of the PPH corresponds to uterine atony. The objective of our study was to evaluate multicenter PPH cases during a 10-month period, and evaluate severe postpartum hemorrhage mana...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | Journal of Pregnancy |
| Online Access: | http://dx.doi.org/10.1155/2013/525914 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562642137382912 |
|---|---|
| author | Carlos Montufar-Rueda Laritza Rodriguez José Douglas Jarquin Alejandra Barboza Maura Carolina Bustillo Flor Marin Guillermo Ortiz Francisco Estrada |
| author_facet | Carlos Montufar-Rueda Laritza Rodriguez José Douglas Jarquin Alejandra Barboza Maura Carolina Bustillo Flor Marin Guillermo Ortiz Francisco Estrada |
| author_sort | Carlos Montufar-Rueda |
| collection | DOAJ |
| description | Objective. Postpartum hemorrhage (PPH) is an important cause of maternal mortality (MM) around the world. Seventy percent of the PPH corresponds to uterine atony. The objective of our study was to evaluate multicenter PPH cases during a 10-month period, and evaluate severe postpartum hemorrhage management. Study Design. The study population is a cohort of vaginal delivery and cesarean section patients with severe postpartum hemorrhage secondary to uterine atony. The study was designed as a descriptive, prospective, longitudinal, and multicenter study, during 10 months in 13 teaching hospitals. Results. Total live births during the study period were 124,019 with 218 patients (0.17%) with severe postpartum hemorrhage (SPHH). Total maternal deaths were 8, for mortality rate of 3.6% and a MM rate of 6.45/100,000 live births (LB). Maternal deaths were associated with inadequate transfusion therapy. Conclusions. In all patients with severe hemorrhage and subsequent hypovolemic shock, the most important therapy is intravascular volume resuscitation, to reduce the possibility of target organ damage and death. Similarly, the current proposals of transfusion therapy in severe or massive hemorrhage point to early transfusion of blood products and use of fresh frozen plasma, in addition to packed red blood cells, to prevent maternal deaths. |
| format | Article |
| id | doaj-art-dae73f20097e4a3e89b5367a876e070b |
| institution | Kabale University |
| issn | 2090-2727 2090-2735 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Pregnancy |
| spelling | doaj-art-dae73f20097e4a3e89b5367a876e070b2025-02-03T01:22:18ZengWileyJournal of Pregnancy2090-27272090-27352013-01-01201310.1155/2013/525914525914Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric StudyCarlos Montufar-Rueda0Laritza Rodriguez1José Douglas Jarquin2Alejandra Barboza3Maura Carolina Bustillo4Flor Marin5Guillermo Ortiz6Francisco Estrada7Critical Care Obstetrics Unit, Complejo Hospitalario, Caja de Seguro Social, Bella Vista, Panama City, PanamaNational Library of Medicine, Lister Hill Center, National Institute of Health, Bethesda, Maryland, USACOMIN-FECASOG, 4a Avenida 14-14 Zona 14, Guatemala City, GuatemalaHospital Mexico, La Uruca, San Jose, Costa RicaHospital Escuela Suyapa, Boulevard Suyapa, Calle La Salud, Tegucigalpa, HondurasHospital Escuela HEODRA, Avenida Poniente, Leon, NicaraguaHospital Nacional Especializado de Maternidad, 25 Avenida Norte y Final Calle Arce, San Salvador, El SalvadorClinica Las Americas, 11 Avenida 11-30 Zona 1, Guatemala City, GuatemalaObjective. Postpartum hemorrhage (PPH) is an important cause of maternal mortality (MM) around the world. Seventy percent of the PPH corresponds to uterine atony. The objective of our study was to evaluate multicenter PPH cases during a 10-month period, and evaluate severe postpartum hemorrhage management. Study Design. The study population is a cohort of vaginal delivery and cesarean section patients with severe postpartum hemorrhage secondary to uterine atony. The study was designed as a descriptive, prospective, longitudinal, and multicenter study, during 10 months in 13 teaching hospitals. Results. Total live births during the study period were 124,019 with 218 patients (0.17%) with severe postpartum hemorrhage (SPHH). Total maternal deaths were 8, for mortality rate of 3.6% and a MM rate of 6.45/100,000 live births (LB). Maternal deaths were associated with inadequate transfusion therapy. Conclusions. In all patients with severe hemorrhage and subsequent hypovolemic shock, the most important therapy is intravascular volume resuscitation, to reduce the possibility of target organ damage and death. Similarly, the current proposals of transfusion therapy in severe or massive hemorrhage point to early transfusion of blood products and use of fresh frozen plasma, in addition to packed red blood cells, to prevent maternal deaths.http://dx.doi.org/10.1155/2013/525914 |
| spellingShingle | Carlos Montufar-Rueda Laritza Rodriguez José Douglas Jarquin Alejandra Barboza Maura Carolina Bustillo Flor Marin Guillermo Ortiz Francisco Estrada Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study Journal of Pregnancy |
| title | Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study |
| title_full | Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study |
| title_fullStr | Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study |
| title_full_unstemmed | Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study |
| title_short | Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study |
| title_sort | severe postpartum hemorrhage from uterine atony a multicentric study |
| url | http://dx.doi.org/10.1155/2013/525914 |
| work_keys_str_mv | AT carlosmontufarrueda severepostpartumhemorrhagefromuterineatonyamulticentricstudy AT laritzarodriguez severepostpartumhemorrhagefromuterineatonyamulticentricstudy AT josedouglasjarquin severepostpartumhemorrhagefromuterineatonyamulticentricstudy AT alejandrabarboza severepostpartumhemorrhagefromuterineatonyamulticentricstudy AT mauracarolinabustillo severepostpartumhemorrhagefromuterineatonyamulticentricstudy AT flormarin severepostpartumhemorrhagefromuterineatonyamulticentricstudy AT guillermoortiz severepostpartumhemorrhagefromuterineatonyamulticentricstudy AT franciscoestrada severepostpartumhemorrhagefromuterineatonyamulticentricstudy |