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Anasthesiol Intensivmed Notfallmed Schmerzther. 2016 Sep;51(9):526-35. doi: 10.1055/s-0042-105937. Epub 2016 Sep 15.

[The new German guideline on postpartum haemorrhage (PPH): essential aspects for coagulation and circulatory therapy].

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS

[Article in German]
Heiko Lier, Dietmar Schlembach, Wolfgang Korte, Christian von Heymann, Susanne Steppat, Maritta Kühnert, Holger Maul, Wolfgang Henrich, Werner Rath, Jürgen Wacker, Franz Kainer, Daniel Surbek, Hanns Helmer

Affiliations

  1. Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln.
  2. Klinik für Geburtsmedizin, Vivantes Klinikum Neukölln, Berlin.
  3. Zentrum für Labormedizin, Hämostase- und Hämophiliezentrum, St. Gallen.
  4. Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Vivantes Klinikum im Friedrichshain, Berlin.
  5. PPH-Leiliniengruppe.

PMID: 27631446 DOI: 10.1055/s-0042-105937

Abstract

Worldwide, post-partum haemorrhage (PHH) remains one of the leading causes for maternal mortality. The German Society of Gynaecology and Obstetrics, the German Midwifes' Society, the German Society of Thrombosis and Haemostasis and the German Society of Anaesthesiology and Intensive Care updated the former guideline. The resulting recommendations are the results of a structured literature search and a formal consensus process and contain all aspects of PPH including diagnosis, causes, risk factors and therapy. Key aspect of the anaesthesiological and haemostatic therapies is the development of an interdisciplinary standard operating procedure containing medical options related to the bleeding's cause and severity as well as the surgical option. For suspected PPH, this guideline emphasizes clinical and laboratory-based diagnostics, as only those will enable an early identification of the bleeding's causes and the resulting causative therapy. Recommendations cover evidence-based application of uterotonics for atony as well as tranexamic acid, calcium, factor concentrates and blood products. Additionally, recommendations are given on the topics of cell salvage, controlled hypotension and restrictive transfusion triggers.

© Georg Thieme Verlag Stuttgart · New York.

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