Rethinking our approach to postpartum haemorrhage and uterotonics

@article{Weeks2015RethinkingOA,
  title={Rethinking our approach to postpartum haemorrhage and uterotonics},
  author={Andrew D. Weeks and James P. Neilson},
  journal={BMJ : British Medical Journal},
  year={2015},
  volume={351}
}
Andrew Weeks and James Neilson suggest that we have inappropriately generalised evidence on the use of uterotonics from uncomplicated births to all births. They call for stronger focus on women with complex births to reduce deaths from postpartum haemorrhage 
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16 Citations
Background Citations
3
Results Citations
1

16 Citations

Citation Type

Citation Type

First‐line uterotonics for treating postpartum haemorrhage: a systematic review and network meta‐analysis
TLDR
This is a protocol for a Cochrane Review (Intervention) to assess the relative effectiveness and produce a clinically meaningful hierarchy of first-line uterotonic drugs for the treatment of postpartum haemorrhage.
The epidemiology and outcomes of women with postpartum haemorrhage requiring massive transfusion with eight or more units of red cells: a national cross‐sectional study
To ascertain the incidence of massive transfusion (MT) in obstetrics in the UK, and describe its management and clinical outcomes.
Postpartum haemorrhage and synthetic oxytocin dilutions in labour
TLDR
Current synthetic oxytocin regimes from across the UK were compared with the 1977 (unchanged) licensed instructions for infusion, and epidural analgesia prior to infusion is now standard for unlicensed regimes, adding complexity to intrapartum care and greater risks of complex births.
PPH Butterfly: a novel device to treat postpartum haemorrhage through uterine compression
TLDR
The PPH Butterfly is the first device designed to replicate BMC while being less invasive, and could potentially be an effective form of PPH management, while also diagnosing the source of the bleeding.
Management of the third stage of labour: (for the Optimal Intrapartum Care series edited by Mercedes Bonet, Femi Oladapo and Metin Gülmezoglu).
  • A. Weeks, S. Fawcus
  • Medicine
    Best practice & research. Clinical obstetrics & gynaecology
  • 2020
Lack of controlled studies investigating the risk of postpartum haemorrhage in cesarean delivery after prior use of oxytocin: a scoping review
TLDR
The evidence for comparative studies investigating the hypothesis whether the risk for PPH is increased in women requiring cesarean section after induction or augmentation of labour is mapped to support the hypotheses that labouring women exposed to exogenous oxytocin require a higher Oxytocin dose after delivery than non-labouring women to prevent uterine atony after cesAREan section.
Evaluation and Treatment of Postpartum Hemorrhage
TLDR
First-line interventions, which include uterine artery embolization and emergency hysterectomy, have high complication rates, but may be lifesaving when first-line therapy is unsuccessful.
Why are women still dying from obstetric hemorrhage? A narrative review of perspectives from high and low resource settings.
Does the use of Oxytocin in the Third Stage of Labour have an Impact on Breastfed Babies Health? Looking for a Viable Alternative
TLDR
This review explains the main reasons why, based on the principle of prudence, it is important to evaluate different drugs from oxytocin for prophylaxis of postpartum hemorrhage (PPH), and presents conceptual arguments and empirical facts in support of this hypothesis.
Postpartum haemorrhage (PPH) rates in randomized trials of PPH prophylactic interventions and the effect of underlying participant PPH risk: a meta-analysis
TLDR
Assessment of trials of PPH prophylaxis showed complex births are often underrepresented in trials and there was no difference in reported PPH rates between studies conducted in high and low risk groups.
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