The most recent UK Confidential Enquiry into Maternal Deaths reports a welcome decline
in mortality as a result of major obstetric haemorrhage (MOH), it now being ranked
the sixth most common cause of direct death.
1
This improvement has in part resulted from better multidisciplinary care, better
surgical techniques, use of interventional radiology and implementation of MOH protocols.
Nevertheless the morbidity associated with MOH continues to be a significant problem.
The Scottish Confidential Audit of Severe Maternal Morbidity Report of 2008
2
identified that MOH was responsible for approximately 80% of all morbidity occurring
in Scottish mothers in the triennium 2006–2008 and MOH is the most common cause of
obstetric-related intensive care admission.
3
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References
Centre for Maternal and Child Enquiries (CMACE). Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–08. The Eighth Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 2011; 118 (Suppl 1): 1–203.
NHS Quality Improvement Scotland. Scottish Confidential Audit of Severe Maternal Morbidity. 6th Annual Report. Edinburgh. NHS QIS; 2010.
- Obstetric intensive care unit admission: a 2-year nationwide population-based cohort study.Intensive Care Med. 2010; 36: 256-263
- Estimation of blood haemoglobin concentration using the HemoCue® during caesarean section: the effect of sampling site.Int J Obstet Anesth. 2010; 19: 67-70
- The accuracy of non-invasive and continuous total hemoglobin measurement by pulse co-oximetry in human subjects undergoing hemodilution.Anesth Anal. 2010; 111: 1424-1426
- Non-invasive measurement of hemoglobin during cesarean hysterectomy: a case series.Int J Obstet Anesth. 2011; 20: 240-245
- A comparison of three methods of hemoglobin monitoring in patients undergoing spine surgery.Anesth Anal. 2011; 112: 858-863
- Pathophysiology and treatment of coagulopathy in massive hemorrhage and hemodilution.Anesthesiology. 2010; 113: 1205-1219
- Obstetric haemorrhage.Thromb Res. 2009; 123: S30-S34
- Association of Anaesthetists of Great Britain and Ireland. Blood transfusion and the anaesthetist: management of massive haemorrhage.Anaesthesia. 2010; 65: 1153-1161
Royal College of Obstetricians and Gynaecologists Green Top 52. Postpartum haemorrhage, prevention and management. 2009 http://www.rcog.org.uk/womens-health/clinical-guidance/prevention-and-management-postpartum-haemorrhage-green-top-52, [accessed June 2011].
- Use of clotting factors and other prohemostatic drugs for obstetric hemorrhage.Curr Opin Anaesthesiol. 2010; 23: 310-316
- Coagulation monitoring: current techniques and clinical use of viscoelastic point-of-care coagulation devices.Anesth Analg. 2008; 106: 1366-1375
Armstrong S, Fernando R, Ashpole K, Simons R, Columb M. Assessment of coagulation in the obstetric population using ROTEM® thromboelastometry. Int J Obstet Anesth 2011;20:xxx–x.
- The association between thromboelastographic parameters and total estimated blood loss in patients undergoing cesarean delivery.Anesth Analg. 2011; 112: 1041-1047
- Bedside assessment of fibrinogen level in postpartum haemorrhage by thromboelastometry.BJOG. 2009; 116: 1097-1102
- ROTEM® thromboelastometry identifies blood product requirements during major obstetric haemorrhage.Int J Obstet Anesth. 2011; 20: S22
NHS Quality Improvement Scotland. HTA programme: Health technology assessment report 11. The clinical and cost effectiveness of thromboelastography/thromboelastometry. Glasgow: NHS Quality Improvement Scotland, 2008.
- A national survey of the presence and utilisation of thromboelastography and thromboelastometry across UK obstetric units.Int J Obstet Anesth. 2011; 20: S20
- Standard haemostatic tests following major obstetric haemorrhage.Int J Obstet Anesth. 2011; 20: 135-141
- The decrease of fibrinogen is an early predictor of severity of postpartum hemorrhage.J Thromb Haemost. 2007; 5: 266-273
- The use of fibrinogen concentrate to correct hypofibrinogenaemia rapidly during obstetric haemorrhage.Int J Obstet Anesth. 2010; 19: 218-234
- Towards early individual goal-directed coagulation management in trauma patients.Br J Anaesth. 2010; 105: 103-105
- Active, personalized, and balanced coagulation management saves lives in patients with massive bleeding.Anesthesiology. 2010; 113: 1016-1018
- Feasibility of using Rotational Thromboelastometry to assess coagulation status of combat casualties in a deployed setting.J Trauma. 2010; 69: S40-S48
Article info
Publication history
Published online: August 16, 2011
Accepted:
June 29,
2011
Identification
Copyright
© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
