Document Detail

Prohemostatic interventions in obstetric hemorrhage.
MedLine Citation:
PMID:  22510859     Owner:  NLM     Status:  In-Data-Review    
Obstetric hemorrhage is a major cause of maternal morbidity and mortality. Pregnancy is associated with substantial hemostatic changes, resulting in a relatively hypercoagulable state. Acquired coagulopathy can, however, develop rapidly in severe obstetric hemorrhage. Therefore, prohemostatic treatments based on high fresh frozen plasma and red blood cell (FFP:RBC) ratio transfusion and procoagulant agents (fibrinogen concentrates, recombinant activated factor VII, and tranexamic acid) are crucial aspects of management. Often, evidence from trauma patients is applied to obstetric hemorrhage management, although distinct differences exist between the two situations. Therefore, until efficacy and safety are demonstrated in obstetric hemorrhage, clinicians should be cautious about wholesale adoption of high FFP:RBC ratio products. Applications of transfusion protocols, dedicated to massive obstetric hemorrhage and multidisciplinarily developed, currently remain the best available option. Similarly, while procoagulant agents appear promising in treatment of obstetric hemorrhage, caution is nonetheless warranted as long as clear evidence in the context of obstetric hemorrhage is lacking.
Marie-Pierre Bonnet; Olga Basso
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Publication Detail:
Type:  Journal Article     Date:  2012-02-18
Journal Detail:
Title:  Seminars in thrombosis and hemostasis     Volume:  38     ISSN:  1098-9064     ISO Abbreviation:  Semin. Thromb. Hemost.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0431155     Medline TA:  Semin Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  259-64     Citation Subset:  IM    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
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