Diagnosis of PPH -- Management of atonic PPH -- Management of retained placenta -- Choice of fluid for replacement or resuscitation -- Health systems and organizational interventions -- PPH care pathways -- Research implications -- Plans for local adaptation of the recommendations -- Plans for supporting implementation of these recommendations -- GRADE tables.
Efforts to prevent and reduce morbidity and mortality due to PPH (Postpartum haemorrhage) can help to address the profound inequities in maternal and perinatal health globally. To achieve this, skilled health personnel, health managers, policy-makers and other stakeholders need up-to-date and evidence-informed recommendations to guide clinical policies and practices. In 2019, the Executive Guideline Steering Group (GSG) for the World Health Organization (WHO) maternal and perinatal health recommendations prioritized updating of the existing WHO recommendation: Umbilical vein injection of oxytocin for the treatment of retained placenta, in response to the availability of new evidence. The recommendation in this document thus supersedes the previous WHO recommendations on "intraumbilical vein injection of oxytocin for treatment of retained placenta" as published in the 2012 guideline, WHO recommendations for the prevention and treatment of postpartum haemorrhage.
Postpartum haemorrhage (PPH) is a major cause of mortality, morbidity and long term disability related to pregnancy and childbirth. Effective interventions to prevent and treat PPH exist and can largely reduce the burden of this life-threatening condition. Given the availability of new scientific evidence related to the prevention and treatment of PPH, this document updates previous WHO recommendations and adds new recommendations for the prevention and treatment of PPH. The primary goal of this guideline is to provide a foundation for the implementation of interventions shown to have been effective in reducing the burden of PPH. Health professionals responsible for developing national and local health policies constitute the main target audience of this document. Obstetricians, midwives, general medical practitioners, health care managers and public health policy-makers, particularly in under-resourced settings are also targeted. This document establishes general principles of PPH care and it is intended to inform the development of clinical protocols and health policies related to PPH.
Global and national confidential inquiry reports show that 60 to 80% of maternal and neonatal morbidity and mortality are due to avoidable errors. This comprehensive and illustrated second edition offers a practical guide to the management of obstetric, medical, surgical, anaesthetic and newborn emergencies in addition to organisational and training issues. The book is divided conveniently into nine sections and updated throughout in line with modern research and practice. Several new chapters cover setting up skills and drills training in maternity services to reduce avoidable harm, managing obstetric emergencies during 'home births' and in low-risk midwifery units, and minimizing maternal and fetal morbidity in failed operative vaginal delivery. Each chapter includes a practical algorithm for quick reference, the scientific basis for proposed actions, a case-based practical exercise and useful learning tools such as 'Key Pearls' and 'Key Pitfalls'. An invaluable resource for obstetricians, neonatologists, midwives, medical students, anesthesiologists and the wider perinatal team.
Understand the rapidly growing complexities of obstetric hematology and high-risk pregnancy management, with experts in the field. Now in its second edition, this comprehensive and essential guide focuses on providing the best support for patients and clinical staff, to prevent serious complications in pregnancy and the post-partum period for both mother and baby. Wide-ranging and detailed, the guide offers discussions on basic principles of best care, through to tackling lesser-known hematological conditions, such as cytopenias and hemoglobinopathies. Updated with color illustrations, cutting-edge research, accurate blood film reproductions, and practical case studies, the revised edition places invaluable advice into everyday context. This unique resource is essential reading for trainees and practitioners in obstetrics, anesthesia, and hematology, as well as midwives, nurses, and laboratory staff. Clarifying difficult procedures for disease prevention, the guide ensures safety when the stakes are high. Reflecting current evidence-based guidelines, the updated volume is key to improving pregnancy outcomes worldwide.
The primary goal of this guideline is to provide a foundation for the implementation of interventions shown to have been effective in reducing the burden of PPH (postpartum haemorrhage). Health professionals responsible for developing national and local health policies constitute the main target audience of this document. Obstetricians, midwives, general medical practitioners, health care managers and public health policy-makers, particularly in under-resourced settings are also targeted. This document establishes general principles of PPH care and it is intended to inform the development of clinical protocols and health policies related to PPH.
The significantly expanded second edition of this full-color atlas provides a step-by-step, visual guide to the most common procedures in emergency medicine. Completely revised, it also includes new procedures such as REBOA, the HINTS test, sphenopalatine ganglion block, occipital nerve block, and lung ultrasonography. Procedures are described on a single page, or two-page spreads, so that the physician can quickly access and review the procedure at hand. The atlas contains more than 700 diagnostic algorithms, schematic diagrams, and photographic illustrations to highlight the breadth and depth of emergency medicine. Topics are logically arranged by anatomic location or by type of procedure, and all procedures are based on the most current and evidence-based practices. Atlas of Emergency Medicine Procedures, Second Edition is an essential resource for physicians and advanced practice professionals, residents, medical students, and nurses in emergency medicine, urgent care, and pediatrics.
Addresses the challenges of managing critically ill obstetric patients, with chapters authored by intensivists/anesthesiologists and obstetricians/maternal-fetal medicine specialists.
Patient Blood Management (PBM) is an innovative clinical concept that aims to reduce the need for allogenic blood transfusions, cut health-care costs, and avert or correct the risk factors related to blood transfusion, thus minimizing the rate of side effects and complications. This comprehensive hands-on volume offers a three-point approach for the implementation of PBM to improve patient outcome, focusing on how to prevent or treat anemia, reduce blood loss, and increase anemia tolerance. The book also goes beyond preoperative PBM, with detailed accounts of coagulation disorder management and the administration of coagulation products and platelet concentrates. Special Features: Presents a clear three-pillar strategy for the application of PBM: diagnosis and treatment of anemia, reduction of peri-interventional blood loss, and optimization of the tolerance to anemia in the everyday clinical setting Covers issues such as PBM during surgery, requirements for modern transfusion medicine, ordering blood products, the role of pre-anesthesia clinics, benchmarking processes, and potential implications of PBM in the public health sector Overview of research in PBM including landmark studies and current clinical trials Boxes in each chapter highlighting key information, core statements, and summaries A multidisciplinary and international team of contributors experienced in PBM Patient Blood Management is a guide for clinicians and residents whose patients are at risk for anemia, coagulation disorders, or severe blood loss. Anesthesiologists, surgeons, and specialists involved in the use of blood and blood products can use the book for quick reference or to learn more about a leading-edge concept for optimizing patient safety and improving outcome.
