Friday, December 28 (2018); Pregnancy, Obstetrics and Gynaecology
Postpartum haemorrhage lacks a standard defintion and most of the international guidelines disagree on basic elemsnts of its management. Most of the time, people define in in terms of volume, that being 500ml in the 24 hours following delivery. Standard peripartum management should include some uterotonic, be it oxytocin, ergometrin or misoprostol. Management of PPH starts with these drugs, moves on to add tranexamic acid and massive 1:1:1 transfusion (maybe even Factor VIIa) and continues through to mechanical compression strategies such as balloon tamponade. Ultimately, definitive management techniques can range from angioembolisation and "stepwise uterine devascularisation" by ligation and finally hysterectomy.