Medical care for postpartum bleeding: A literature review

Abstract

Relevance: According to modern literature, over the past decade, there has been no tendency in the world to reduce maternal mortality from postpartum hemorrhage (PPH). In Kazakhstan, evidence-based medicine clinical recommendations on prevention and algorithm of action for obstetric bleeding have been developed and recommended for use since 2010. We conducted a literary search for existing innovative methods of PPH prevention and treatment based on the study of clinical recommendations of many developed countries, WHO, FIGO, and scientific publications. There exist separate algorithms for managing PPH during vaginal delivery or cesarean section.The study aimed to explore the existing innovative methods of preventing and treating postpartum hemorrhage to determine the most effective medical care for postpartum hemorrhage.Materials and methods: The literature search included papers published on PubMed in English from January 1, 2018, to November 31, 2022. The search was done by keywords including “pregnancy,” “PPH,” “pregnancy complication,” “pregnancy outcomes,” and “tranexamic acid,” “guideline.” Results: Today, there are separate algorithms for managing PPH during vaginal delivery or cesarean section. Fibrin preparations and fibrinogen concentrate are recommended for use. When PPH occurs, it is important to communicate with family members to further inform them about the patient’s condition. The routine use of the Allgower shock index for accurate calculation of the volume of blood loss is proposed. It is proposed to use antifibrinolytic drugs not only for therapeutic purposes but also for prophylactic purposes. It is important to carry out adequate infusion-transfusion therapy to prevent iatrogenic coagulopathy. Conclusion: Introducing the above modern technologies into practical healthcare does not require high economic costs and can be used in obstetric institutions at all levels of medical care for PPH.