SCCM Resource Library-Pharmacologic Adjuncts in Obstetric Hemorrhage: First Line and Beyond

Video Transcription

Video Summary

In this video, Mary Jane Reed discusses pharmacological adjuvants in the treatment of obstetrical hemorrhage. Obstetrical hemorrhage is a major cause of maternal death worldwide, and it is important to recognize the risk factors and take appropriate measures to prevent and treat it. The lecture covers various pharmacological prophylactics and adjuvants, including oxytocin, carboprost, misoprostol, ergotamine derivatives, and transamic acid. Oxytocin is the preferred drug for preventing postpartum hemorrhage, given either intravenously or intramuscularly. Carboprost is an injectable prostaglandin that can be used as a last resort treatment for non-responsive cases. Misoprostol is a cheaper alternative to oxytocin, but less effective for severe postpartum hemorrhage. Ergotamine derivatives have similar effects to oxytocin but come with more side effects and should be avoided in patients with hypertension. Transamic acid is a promising adjuvant that reduces blood loss, but careful consideration is necessary due to potential side effects. The lecture concludes by discussing the use of repeated oxytocin doses and the need for further research in this area.

Asset Subtitle

Pharmacology, 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 Pharmacology

Knowledge Area Obstetrics

Knowledge Area Hematology

Knowledge Level Advanced

Membership Level Select

Tag Pharmacology

Tag Obstetrics

Tag Hemorrhage

Year 2022

Keywords

pharmacological adjuvants

obstetrical hemorrhage

oxytocin

carboprost

misoprostol

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