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Postpartum haemorrhage: prevention.

David Chelmow¹

¹Tufts Medical Center, Boston, USA.

BMJ Clinical Evidence

|May 19, 2009

Summary

This summary is machine-generated.

Preventing postpartum hemorrhage (PPH) involves various drug and non-drug interventions. This systematic review evaluates the effectiveness and safety of options like oxytocin, misoprostol, and uterine massage for PPH prevention.

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Area of Science:

Obstetrics and Gynecology
Pharmacology
Evidence-Based Medicine

Background:

Postpartum hemorrhage (PPH), often due to uterine atony, affects over 10% of deliveries globally.
It carries a significant mortality rate and can result from various factors including anesthesia, uterine overdistension, and prolonged labor.

Purpose of the Study:

To systematically review and evaluate the effectiveness and safety of pharmacological and non-pharmacological interventions for preventing primary postpartum hemorrhage.

Main Methods:

A systematic review was conducted, searching major databases up to September 2007.
Included were 29 systematic reviews, randomized controlled trials (RCTs), and observational studies.
GRADE methodology was used to evaluate the quality of evidence for interventions.

Main Results:

The review identified numerous interventions for PPH prevention.
Evidence quality for each intervention was assessed using the GRADE system.

Conclusions:

The systematic review provides information on the effectiveness and safety of interventions such as active management of the third stage of labor, oxytocin, ergometrine, misoprostol, and uterine massage.
These findings aid in selecting appropriate strategies to prevent primary postpartum hemorrhage.