Standardized Management Protocol in Severe Postpartum Hemorrhage: A Single-Center Study.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY-NC 4.0
ID Serval
serval:BIB_A175FB499820
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Standardized Management Protocol in Severe Postpartum Hemorrhage: A Single-Center Study.
Périodique
Clinical and applied thrombosis/hemostasis
Auteur(s)
Colucci G., Helsing K., Biasiutti F.D., Raio L., Schmid P., Tsakiris D.A., Eberle B., Surbek D., Lämmle B., Alberio L.
ISSN
1938-2723 (Electronic)
ISSN-L
1076-0296
Statut éditorial
Publié
Date de publication
09/2018
Peer-reviewed
Oui
Volume
24
Numéro
6
Pages
884-893
Langue
anglais
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
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.
Mots-clé
Adult, Erythrocyte Transfusion, Factor VIIa/administration & dosage, Female, Humans, Hysterectomy, Postpartum Hemorrhage/therapy, Recombinant Proteins/administration & dosage, Retrospective Studies, blood coagulation disorders, hemostatics, hysterectomy, postpartum hemorrhage, pregnancy complications
Pubmed
Web of science
Open Access
Oui
Création de la notice
26/04/2018 18:28
Dernière modification de la notice
20/08/2019 15:07
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