Postpartum Hemorrhage

Excess blood loss from uterine bleeding associated with OBSTETRIC LABOR or CHILDBIRTH. It is defined as blood loss greater than 500 ml or of the amount that adversely affects the maternal physiology, such as BLOOD PRESSURE and HEMATOCRIT. Postpartum hemorrhage is divided into two categories, immediate (within first 24 hours after birth) or delayed (after 24 hours postpartum).

Also Known As:

Networked: 934 relevant articles (67 outcomes, 91 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Uterine Inertia
2.	Lacerations
3.	Hemorrhage
4.	Endometritis
5.	Wounds and Injuries (Trauma)

Experts

1.	Matsubara, Shigeki: 8 articles (01/2015 - 08/2009)
2.	Sentilhes, Loïc: 7 articles (04/2015 - 01/2008)
3.	Joseph, K S: 7 articles (04/2015 - 09/2005)
4.	Prata, Ndola: 7 articles (06/2014 - 02/2009)
5.	Baskett, Thomas F: 6 articles (08/2015 - 12/2002)
6.	Grobman, William A: 6 articles (08/2015 - 04/2005)
7.	Mazor, Moshe: 6 articles (04/2015 - 08/2003)
8.	Kramer, Michael S: 6 articles (04/2015 - 09/2005)
9.	Miller, Suellen: 6 articles (01/2012 - 07/2004)
10.	Suzuki, Shunji: 5 articles (09/2015 - 12/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Postpartum Hemorrhage:

1.	Oxytocin (Pitocin)FDA LinkGeneric 03/01/2005 - "Postpartum hemorrhage (PPH) is the single most common cause of maternal death in the world, and oxytocin is known to be effective for its prevention and treatment. " 02/01/2012 - "Higher-dose oxytocin is more effective than lower-dose regimens to prevent postpartum hemorrhage after cesarean delivery. " 02/01/2012 - "Uterotonic drugs are recommended for the prevention and treatment of postpartum hemorrhage (PPH), and oxytocin is considered the gold standard for both indications due to its established efficacy and safety. " 10/01/2003 - "Oxytocin via Uniject holds promise for safer, more convenient use of oxytocin by trained midwives attending home deliveries, thereby potentially reducing the incidence of postpartum hemorrhage." 12/01/2012 - "Training auxiliary nurses to perform AMTSL using oxytocin in this birth center setting was effective in reducing the rate of postpartum hemorrhage; however, increased use of intrapartum oxytocin may be an unintended outcome of the increased accessibility of oxytocin."
2.	Misoprostol (Cytotec)FDA LinkGeneric 01/01/2012 - "Clinical and operational evidence indicates that misoprostol is a safe and effective technology for addressing postpartum hemorrhage, a major cause of maternal death. " 09/01/2011 - "In recent two decades, misoprostol has approved to be an effective agent for termination of pregnancy in various gestation, cervical ripening, labor induction in term pregnancy, and possible management of postpartum hemorrhage. " 12/01/2007 - "A literature review was conducted to determine whether misoprostol is an effective treatment for postpartum hemorrhage (PPH) and in what dose. " 08/01/1999 - "Oral misoprostol administered in the third stage of labor reduced postpartum blood loss and might be effective in reducing incidence of postpartum hemorrhage." 08/01/1998 - "To investigate whether rectally administered misoprostol is an effective treatment for postpartum hemorrhage unresponsive to conventional first-line management. "
3.	Ergonovine (Ergometrine)IBA 07/01/1997 - "A placebo-controlled trial of oral ergometrine to reduce postpartum hemorrhage." 05/01/1996 - "A placebo-controlled trial of oral ergometrine to reduce postpartum hemorrhage." 01/01/1999 - "Fourteen women with established postpartum hemorrhage not responding to oxytocine and ergometrine regimens, or not responsive to oxytocine and having contraindications to ergometrine. " 05/01/1996 - "Active management with oral ergometrine 0.4 mg was compared with expectant management for the control of blood loss in the third stage of labor in women at low risk of postpartum hemorrhage (PPH). " 09/01/1965 - "Prevention of postpartum hemorrhage with ergonovine: an analysis of 19,510 cases."
4.	Methylergonovine (Methergine)FDA LinkGeneric 05/01/2011 - "Methylergonovine (MEV) is a semi-synthetic ergot alkaloid used in the prevention and control of postpartum hemorrhage. " 10/25/1957 - "[Directed methergine administration in prevention of postpartum hemorrhage]." 01/01/1952 - "[Methergine in prophylaxis of postpartum hemorrhage]." 06/15/2015 - "Cesarean Delivery in a Parturient with Left Ventricular Noncompaction Complicated by Acute Pulmonary Hypertension After Methylergonovine Administration for Postpartum Hemorrhage." 03/01/2008 - "To assess the efficacy of rectal misoprostol as second-line therapy in the management of primary postpartum hemorrhage (PPH) as compared to methylergonovine maleate. "
5.	carbetocinIBA 02/01/2016 - "Carbetocin for the prevention of postpartum hemorrhage: a systematic review and meta-analysis of randomized controlled trials." 02/01/2016 - "To compare the efficacy and safety profile of carbetocin with other uterotonic agents in preventing postpartum hemorrhage. " 02/01/2009 - "The objective of this review was to evaluate the efficacy and safety of carbetocin in the prevention of postpartum hemorrhage. " 02/01/2009 - "Carbetocin for the prevention of postpartum hemorrhage: a systematic review." 07/01/2009 - "Carbetocin appears to be an effective new drug in the prevention of postpartum hemorrhage, not only among women undergoing cesarean section but also in the group of women with PPH risk factors."
6.	ProstaglandinsIBA 09/01/2012 - "It is unclear whether this phenomenon affects the contractions produced by various prostaglandins that are used in the management of postpartum hemorrhage. " 09/01/1987 - "Parenteral administration of prostaglandins in the F2 alpha family, agents with known vasoconstrictive properties, is useful in the control of postpartum hemorrhage. " 09/01/1978 - "Prostaglandins have found clinical applications in: 1) termination of midtrimester pregnancy; 2) induction of labor; 3) menstrual regulation; and 4) control of postpartum hemorrhage. " 04/01/2011 - "Postpartum hemorrhage due to uterine atony, which was successfully treated with prostaglandins, occurred." 01/01/2013 - "The studied outcome was maternal complications defined as composite item including the occurrence of a third- or fourth-degree perineal laceration, or the occurrence of severe postpartum hemorrhage requiring the use of prostaglandins, uterine artery embolization, internal iliac artery ligation or haemostatic hysterectomy, or the occurrence of blood transfusion. "
7.	OxytocicsIBA 07/01/1994 - "For women in developing countries where parenteral oxytocics are not available, nipple stimulation might reduce the incidence of postpartum hemorrhage. " 03/01/1985 - "Following delivery, the physician should be on the lookout for postpartum hemorrhage, which may necessitate immediate transfusion, the administration of oxytocics, and/or uterine manipulation. " 11/01/1952 - "A management of postpartum hemorrhage by prolonged administration of oxytocics." 03/01/1997 - "Immediate postpartum hemorrhage due to uterine inertia is usually treated by injection of oxytocics. " 01/01/2006 - "Oral misoprostol is as effective as conventional oxytocic agents in preventing postpartum hemorrhage and can be recommended for use in low-resource settings."
8.	Estrogens (Estrogen)FDA Link 01/01/2007 - "Two cases of postpartum hemorrhage were found in estrogen group and 10 in control group. " 01/01/2007 - "[Value of estrogen for preventing postpartum hemorrhage and shortening birth process in induce abortion]." 06/01/2006 - "[Clinical value of adjuvant therapy with estrogen for postpartum hemorrhage]." 01/01/2007 - "Estrogen given before delivery can be effective in stimulating uterine contraction for preventing postpartum hemorrhage and shortening the birth process in women undergoing induced abortion." 01/01/2007 - "To investigate the clinical efficacy of estrogen in preventing postpartum hemorrhage and shortening the birth process during induced abortion. "
9.	syntometrineIBA 02/01/2016 - "Studies comparing carbetocin with syntometrine in women undergoing vaginal delivery demonstrated no statistical difference in terms of risk of postpartum hemorrhage, severe postpartum hemorrhage or the need for additional uterotonic agents, but the risk of adverse effect was significantly lower in the carbetocin group. " 09/01/2013 - "The aim of this study was to compare the efficacy between carbetocin and syntometrine in prevention of postpartum hemorrhage. " 09/01/2013 - "Carbetocin vs. Syntometrine in Prevention of Postpartum Hemorrhage: a Double Blind Randomized Control Trial." 12/01/2011 - "To assess and compare the efficacy and safety of a single intramuscular dose of carbetocin to a single intramuscular dose of syntometrine in managing the third stage of labor following vaginal delivery among women with low risk factors for postpartum hemorrhage. " 12/01/2001 - "There was no significant difference in the rate of postpartum hemorrhage for syntometrine compared with oxytocin, when used at the end of the 2nd stage of labor (odds ratio 1.08, 95% confidence interval 0.72-1.63) or after the 3rd stage (odds ratio 0.93, 95% confidence interval 0.65-1.34). "
10.	recombinant FVIIa (rFVIIa)IBA 04/01/2011 - "Our goal was to evaluate the safety and efficacy of rFVIIa use in obstetric patients with massive postpartum hemorrhage (MPH). " 02/01/2008 - "Nevertheless, although these reports suggest the potential role of rFVIIa in treating massive postpartum hemorrhage refractory to standard therapy, we advise particular caution in interpreting these results, as they are derived from few and uncontrolled studies. " 02/01/2008 - "These studies incorporated 118 cases of massive postpartum hemorrhage treated with rFVIIa. " 06/01/2012 - "To review the literature regarding the use of recombinant activated factor FVII (rFVIIa) in the treatment of postpartum hemorrhage (PPH). " 04/01/2011 - "Massive postpartum hemorrhage: recombinant factor VIIa use is safe but not effective."

Therapies and Procedures

1.	Sutures (Suture) 10/01/2011 - "Multiple square sutures are effective and safe for the control of severe postpartum hemorrhage and for uterine conservation in most cases. " 09/01/2011 - "Uterine compression sutures as an effective treatment for postpartum hemorrhage: case series." 11/01/2013 - "The present study showed that the B-Lynch suture is an effective and safe surgical option for treatment of intractable postpartum hemorrhage with no apparent adverse outcomes. " 02/01/2014 - "VV compression sutures comprise an easy, safe and effective procedure that can be applied in cases of atonic postpartum hemorrhage." 06/01/2010 - "Uterine compression suture is a safe and effective technique for hemostasis in postpartum hemorrhage. "
2.	Hysterectomy 11/01/2003 - "Pelvic arterial embolization is a safe and effective procedure and offers patients a fertility-preserving alternative to hysterectomy for treatment of intractable postpartum hemorrhage." 07/01/2001 - "Embolization of acute postpartum hemorrhage is a safe and effective alternative to hysterectomy." 09/01/1994 - "Stepwise uterine devascularization is an effective and safe alternative to hysterectomy for management of uncontrollable postpartum hemorrhage." 09/01/2015 - "The risks of postpartum hemorrhage (PPH) and hysterectomy were statistically significantly lower in the study group (PPH, 54.5% vs 15.8%; P = 0.035; hysterectomy, 27.3% vs 0.0%; P = 0.045). " 09/01/2014 - "Twenty-one Australian women, aged 24 to 57 years, who had experienced severe postpartum hemorrhage and emergency hysterectomy were interviewed in an in-depth qualitative study about their experiences. "
3.	Cesarean Section (Caesarean Section) 12/01/2009 - "The present study analyzed one postpartum hemorrhage woman compared to three women who gave birth in nearly the same period and had no postpartum hemorrhage both vaginal deliveries and cesarean section. " 09/01/2007 - "[Clinical study on prevention of postpartum hemorrhage of cesarean section using hemabat in high risk pregnant women]." 12/01/2001 - "[Study on postpartum hemorrhage in cesarean section in Nanjing]." 03/01/2015 - "It is increasing in incidence because of increasing number of cesarean sections and is one of the main causes of excessive postpartum hemorrhage. " 01/01/2015 - "Does uterine gauze packing increase the risk of puerperal morbidity in the management of postpartum hemorrhage during caesarean section: a retrospective cohort study."
4.	Balloon Occlusion 11/01/2001 - "In this case report we describe two patients with life-threatening postpartum hemorrhage who were treated successfully with arterial balloon occlusion of the hypogastric arteries. " 10/01/2012 - "The purpose of this study was to investigate changes in invasive procedure rates after the addition of intrauterine balloon tamponade as an initial second-line therapy to our protocol for the management of severe postpartum hemorrhage. " 06/01/2015 - "To evaluate the success rate of Bakri balloon tamponade (BBT) for managing postpartum hemorrhage (PPH), intractable to conservative medical treatment, as a fertility sparing intervention. " 06/01/2015 - "The fertility sparing management of postpartum hemorrhage: A series of 47 cases of Bakri balloon tamponade." 04/01/2015 - "Balloon tamponade is an effective, safe and readily available method for treating primary postpartum hemorrhage and could reduce the need for invasive procedures."
5.	Uterine Artery Embolization 01/01/2008 - "Uterine artery embolization is a safe and effective procedure for managing massive postpartum hemorrhage." 08/01/2011 - "We evaluated the efficacy of uterine artery embolization (UAE) for controlling postpartum hemorrhage (PPH). " 07/01/2015 - "A uterine artery embolization was performed on a 42-year-old woman to treat a postpartum hemorrhage. " 04/01/2015 - "Uterine artery embolization (UAE) is a standard method for treating postpartum hemorrhage (PPH), although uterine artery vasospasm during UAE may lead to failure of hemostasis. " 01/01/2015 - "Although pregnancy-related outcomes remain understudied, the available reports evidence that pregnancies after uterine artery embolization may be at significantly increased risk for postpartum hemorrhage, cesarean delivery, abnormal placentation, and malpresentation. "