| Postpartum hemorrhage-update on problems of definitions and diagnosis. | |
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MedLine Citation:
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PMID: 21332452 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Maternal mortality due to postpartum hemorrhage (PPH) continues to be one of the most important causes of maternal death worldwide. PPH is a significantly underestimated obstetric problem, primarily because a lack in terms of its definition and diagnosis. The 'traditional' definition of primary PPH based on quantification of blood loss has several limitations: Notoriously blood loss is not measured or is significantly underestimated by visual estimation and there are no generally accepted cut-offs limits for estimated blood loss. A definition based on hematocrit change is not clinically useful in an emergency like PPH, since postpartum hematocrit decline shows poor correlation with acute blood loss. The need for erythrocyte transfusion alone to define PPH is also of limited value as the practice of blood transfusion varies widely. Definitions based on symptoms of hemodynamic instability are problematic, since they are late signs of depleted blood volume and commencing failure of compensatory mechanisms threatening the mother's life. There is thus currently no single, satisfactory definition of primary PPH. Proper and timely diagnosis of PPH should above all include accurate estimation of blood loss before vital signs change. Estimation of blood loss by calibrated bags has shown to be significantly more accurate than visual estimation at vaginal delivery. Careful monitoring of the mother's vital signs, laboratory tests, in particular coagulation testing, and immediate diagnosis of the cause of PPH are important key factors to reduce maternal morbidity and mortality. |
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Authors:
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Werner H Rath |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-18 |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: - ISSN: 1600-0412 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Authors AOGS© 2011 Nordic Federation of Societies of Obstetrics and Gynecology. |
Affiliation:
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Faculty of Medicine, University Hospital RWTH Aachen, Division of Obstetrics and Gynecology, Aachen, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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