Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Postpartum hemorrhage
Postpartum hemorrhage (PPH) is a loss of blood greater than 500 ml,
following vaginal delivery, or 1000 ml, following cesarean section.The
mortility rate is of 1000 women per 100,000 live births as a result of
Postpartum hemorrhage (PPH). In the evaluation of all randomly assigned
participants,active bleeding was
controlled within 20 min with study treatment alone for 440 (90%) women
given misoprostol and 468 (96%) given oxytocin (relative risk [RR] 0·94,
95% CI 0·91—0·98; crude difference 5·3%, 95% CI 2·6—8·6). Additional
blood loss of 300 mL or greater after treatment occurred for 147 (30%)
of women receiving misoprostol and 83 (17%) receiving oxytocin (RR 1·78,
95% CI 1·40—2·26). Shivering (229 [47%] vs 82 [17%]; RR 2·80, 95% CI 2·25—3·49) and fever (217 [44%] vs
27 [6%]; 8·07, 5·52—11·8) were significantly more common with
misoprostol than with oxytocin. No women had hysterectomies or died(1).
Treatments
According to the researchers at the Department of Obstetrics and
Gynecology, Orbis Medical Centre, in the current treatment of severe
PPH, first-line therapy includes
transfusion of packed cells and fresh-frozen plasma in addition to
uterotonic medical management and surgical interventions. In persistent
PPH, tranexamic acid, fibrinogen, and coagulation factors are often administered. Secondary coagulopathy
due to PPH or its treatment is often underestimated and therefore
remains untreated, potentially causing progression to even more severe
PPH. In most cases, medical and transfusion therapy is not based on the
actual coagulation
state because conventional laboratory test results are usually not
available for 45 to 60 minutes. Thromboelastography and rotational
thromboelastometry are point-of-care coagulation tests. A good correlation has been shown between thromboelastometric and conventional coagulation
tests, and the use of these in massive bleeding in nonobstetric
patients is widely practiced and it has been proven to be
cost-effective. Fibrinogen
seems to play a major role in the course of PPH and can be an early
predictor of the severity of PPH. The FIBTEM values (in
thromboelastometry, reagent specific for the fibrin polymerization
process) decline even more rapidly than fibrinogen levels and can be
useful for early guidance of interventions(12).
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(1) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961924-3/abstract
(12) http://www.ncbi.nlm.nih.gov/pubmed/22430921
No comments:
Post a Comment