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Postpartum Hemorrhage: A Comprehensive Review of Medical and Surgical Treatment
Avery Lin Cox1, Scott A Shainker1,2
1Department of Obstetrics, Gynecology, and Reproductive Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Abstract:
Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. The incidence of PPH continues to rise. PPH is often responsive to both medical and surgical treatment. A stepwise multidisciplinary approach to PPH treatment has been shown to reduce maternal morbidity. Massive transfusion protocols are critical to any obstetrics unit. Intrauterine devices are often employed in the treatment of PPH. Placenta accreta spectrum greatly contributes to the PPH burden. Hysterectomy remains the definitive treatment of PPH; however, medical and surgical options are often successfully employed, avoiding the need for hysterectomy. Advances in interventional radiology have been shown to successfully treat PPH in the majority of cases. Clinical simulation has been shown to improve teamwork and outcomes in the treatment of PPH. Novel approaches to PPH show additional promise in reducing maternal morbidity.
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