SCCM Resource Library-Obstetric Hemorrhage for the Intensivist: Stopping the Major Cause of Global Maternal Mortality

Video Transcription

Video Summary

Obstetric hemorrhage is a major cause of maternal mortality, particularly in developing countries. It accounts for more than 50% of the 300,000 maternal deaths globally. The most common cause of obstetric hemorrhage is uterine atony, which refers to the failure of the uterus to contract and compress the spiral arteries, leading to excessive bleeding.<br /><br />There are several risk factors for obstetric hemorrhage, including cesarean deliveries, which can increase the risk of placenta accreta and emergency hysterectomies. Other causes include retained placental tissue, coagulopathy, and trauma.<br /><br />Management of obstetric hemorrhage involves a multidisciplinary approach. Medical interventions such as the use of uterotonic medications like oxytocin, methylergonovine, and prostaglandins can help manage uterine atony. In severe cases, surgical interventions like balloon tamponade, uterine artery ligation, or hysterectomy may be necessary.<br /><br />Fluid resuscitation is important to restore blood volume, and blood products like packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate may be transfused to correct coagulopathy.<br /><br />Early recognition and aggressive management of obstetric hemorrhage can significantly reduce maternal mortality and complications. It is crucial to establish protocols and coordinate care between obstetricians, intensivists, and other healthcare professionals to ensure prompt and effective treatment.

Asset Subtitle

Obstetrics, Hematology, 2022

Asset Caption

Physiologic changes in blood volume and hemostasis that accompany pregnancy mitigate the risk of maternal hemorrhage; however, these adaptive mechanisms can be overcome in superimposed pathophysiologic states. Uterotonic and hemostatic adjuncts constitute the first line of defense in combatting postpartum hemorrhage. Familiarity with the indications, contraindications, and pharmacokinetics of these agents is critical for the continued successful management of hemorrhage in the ICU. Early recognition and management are therefore critical because failure to treat potential contributors to hemorrhage can lead to adverse outcomes.

Meta Tag

Content Type Presentation

Knowledge Area Obstetrics

Knowledge Area Hematology

Knowledge Level Advanced

Membership Level Select

Tag Obstetrics

Tag Hemorrhage

Year 2022

Keywords

Obstetric hemorrhage

maternal mortality

developing countries

uterine atony

risk factors

management

medical interventions

surgical interventions

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