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Medical prevention and treatment of postpartum hemorrhage: a comparison of different guidelines

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Postpartum hemorrhage (PPH) remains a common cause of maternal mortality worldwide, mainly caused by uterine atony. Medical intervention plays an important part in prevention and therapies of PPH. Prophylactic interventions include the use of uterotonic drugs. We elaborated the consistency of national and international guidelines on those medical approaches.

Materials and methods

Medical approaches in PPH were extracted from recent publications. Furthermore, the current guidelines of the World Health Organization, the FIGO and of the American, British, Canadian and German Societies of Obstetricians and Gynecologists on PPH were analyzed.

Results

Oxytocin is considered as therapy of first choice. However, the examined guidelines fail to give unequivocal recommendations on further uterotonics in PPH, which may partially be attributed to differing publication dates of the guidelines.

Conclusion

International guidelines on PPH are characterized by differing recommendations. However, recent publications suggest that adhering to local guidelines significantly reduces the prevalence of severe PPH.

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Abbreviations

ACOG:

American Congress of Obstetricians and Gynecologists

DGGG:

German Society for Gynecology and Obstetrics

FIGO:

Fédération Internationale de Gynécologie et d’ Obstétrique

PPH:

Postpartum hemorrhage

RCOG:

Royal College of Obstetricians and Gynaecologists

SOGC:

Society of Obstetricians and Gynaecologists of Canada

WHO:

World Health Organization

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  1. Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Lübeck, Germany

    Michael K. Bohlmann

  2. Division of Obstetrics and Gynecology, Faculty of Medicine, University Hospital Aachen, Aachen, Germany

    Werner Rath

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Bohlmann, M.K., Rath, W. Medical prevention and treatment of postpartum hemorrhage: a comparison of different guidelines. Arch Gynecol Obstet 289, 555–567 (2014). https://doi.org/10.1007/s00404-013-3016-4

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