Postpartum haemorrhage: latest developments in prediction, drug treatment and monitoring

Thuan Phan, Andrew D Weeks
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Abstract

With increasing global rates of postpartum haemorrhage, recent developments aim to ensure that birthing women are safe. This focused review will discuss developments in prediction of postpartum haemorrhage, blood loss measurement, uterotonic use and the thromboelastogram, aiming to improve prevention and treatment of postpartum haemorrhage. The unpredictable nature of postpartum haemorrhage is a significant hurdle, as all women must be considered at risk, imposing a heavy burden on healthcare services. Evidence-based tools have shown promise in improving prediction and management strategies. However, the lack of consensus and agreement on risk factors presents obstacles to developing accurate models. Ongoing research is exploring the development of an individual postpartum haemorrhage risk index, providing personalised care to pregnant women. Accurate blood loss quantification is essential for prompt postpartum haemorrhage diagnosis and appropriate interventions, but challenging in busy clinical settings. Recent advancements in prophylaxis and treatment using medication (uterotonics and tranexamic acid), as well as in monitoring using thromboelastograms, emphasise the need for effective prediction and management strategies. This critical review underscores the need for further research to enhance prediction tools, refine management protocols and address existing challenges to improve maternal outcomes.
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产后出血:预测、药物治疗和监测方面的最新进展
随着全球产后出血率的不断上升,最近的发展旨在确保分娩妇女的安全。这篇重点综述将讨论产后出血预测、失血量测量、宫缩剂使用和血栓弹力图等方面的发展,旨在改善产后出血的预防和治疗。产后出血的不可预测性是一个重大障碍,因为必须将所有产妇都视为高危产妇,这给医疗服务带来了沉重负担。以证据为基础的工具已显示出改善预测和管理策略的希望。然而,由于缺乏对风险因素的共识和一致意见,准确模型的开发面临障碍。目前正在进行的研究正在探索开发个人产后出血风险指数,为孕妇提供个性化护理。准确量化失血量对于及时诊断产后出血和采取适当的干预措施至关重要,但在繁忙的临床环境中却极具挑战性。最近,在使用药物(子宫收缩剂和氨甲环酸)进行预防和治疗以及使用血栓弹力图进行监测方面取得的进展,强调了有效预测和管理策略的必要性。本评论强调了进一步研究的必要性,以加强预测工具、完善管理方案并应对现有挑战,从而改善孕产妇的预后。
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来源期刊
British Journal of Midwifery
British Journal of Midwifery Nursing-Maternity and Midwifery
CiteScore
1.30
自引率
0.00%
发文量
95
期刊介绍: British Journal of Midwifery (BJM) is the leading clinical journal for midwives. Published each month, the journal is written by midwives for midwives and peer reviewed by some of the foremost authorities in the profession. BJM is essential reading for all midwives. It contains the best clinical reviews, original research and evidence-based articles available, and ensures that midwives are kept fully up-to-date with the latest developments taking place in clinical practice. In addition, each issue of the journal contains a symposium on a particular theme, providing more in-depth clinical information.
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