Cutting-edge advances in the medical management of obstetrical hemorrhage

Hemorrhagic shock is the most common form of shock encountered in obstetric practice. Interventions that may limit transfusion requirements include normovolemic hemodilution, use of recombinant activated factor VII, selective embolization of pelvic vessels by interventional radiology, and the use of...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2011-12, Vol.205 (6), p.526-532
Main Authors: Pacheco, Luis D., MD, Saade, George R., MD, Gei, Alfredo F., MD, Hankins, Gary D.V., MD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood Transfusion - standards
Female
Gynecology. Andrology. Obstetrics
hemorrhage
hemostatic resuscitation
Humans
Medical sciences
Obstetrics and Gynecology
Placenta Accreta - therapy
Postpartum Hemorrhage - therapy
Pregnancy
Resuscitation - methods
Shock, Hemorrhagic - therapy
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Summary:Hemorrhagic shock is the most common form of shock encountered in obstetric practice. Interventions that may limit transfusion requirements include normovolemic hemodilution, use of recombinant activated factor VII, selective embolization of pelvic vessels by interventional radiology, and the use of the cell saver intraoperatively. Current understanding of the mechanisms of acute coagulopathy calls into question the current transfusion guidelines, leading to a tendency to apply massive transfusion protocols based on hemostatic resuscitation despite lack of prospective data.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2011.06.009