[Multidisciplinary management of post-partum hemorrhage: new strategies]

Post-partum hemorrhage (PPH) is a dramatic obstetrical complication, responsible for one maternal death every 4 minutes in the world. Clinical management requires prevention, coordination and multidisciplinary care. Whatever the etiology, it is based on a stepwise approach. Prevention begins with active management of the delivery. In case of PPH, uterine and genital revision is essential. Once placental or traumatic etiologies have been excluded, uterotonics and hemostatic obstetrical maneuvers must be initiated. Resuscitation efforts, transfusion and hemostatic strategies must be continuous and adapted. In case of failure, selective embolization of pelvic arteries can sometimes avoid surgery. Exploratory laparotomy with haemostatic sutures is another option, followed if necessary, by a hysterectomy.