Postpartum hemorrhage: guidelines for clinical practice from the French ă College of Gynaecologists and Obstetricians (CNGOF) in collaboration ă with the French Society of Anesthesiology and Intensive Care (SFAR)

Loïc Sentilhes, Christophe Vayssière (), Catherine Deneux-Tharaux, Antoine Guy Aya, Francoise Bayoumeu, Marie-Pierre Bonnet, Rachid Djoudi, Patricia Dolley, Michel Dreyfus, Chantal Ducroux-Schouwey, Corinne Dupont, Anne François, Denis Gallot, Jean-Baptiste Haumonté, Cyril Huissoud, Gilles Kayem, Hawa Keïta, Bruno Langer, Alexandre Mignon, Olivier Morel, Olivier Parant, Jean-Pierre Pelage, Emmanuelle Phan, Mathias Rossignol, Véronique Tessier, Frederic J. Mercier and François Goffinet
Additional contact information
Loïc Sentilhes: Service d'Obstétrique et Gynécologique [Angers] - CHU Angers - Centre Hospitalier Universitaire d'Angers - UNAM - PRES Université Nantes Angers Le Mans
Christophe Vayssière: LEASP - Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale
Catherine Deneux-Tharaux: CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité - INRA - Institut National de la Recherche Agronomique - UPD7 - Université Paris Diderot - Paris 7 - UPD5 - Université Paris Descartes - Paris 5 - USPC - Université Sorbonne Paris Cité - INSERM - Institut National de la Santé et de la Recherche Médicale
Antoine Guy Aya: CHU Nîmes - Centre Hospitalier Universitaire de Nîmes, EA 2992 - Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires - UM1 - Université Montpellier 1 - UM - Université de Montpellier
Marie-Pierre Bonnet: UMR_S 953 - Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants - UP11 - Université Paris-Sud - Paris 11 - UPMC - Université Pierre et Marie Curie - Paris 6 - UPD5 - Université Paris Descartes - Paris 5 - INSERM - Institut National de la Santé et de la Recherche Médicale
Patricia Dolley: Service de Gynécologie-Obstétrique et Médecine de la Reproduction [CHU Caen] - UNICAEN - Université de Caen Normandie - NU - Normandie Université - CHU Caen - NU - Normandie Université - TCBN - Tumorothèque de Caen Basse-Normandie
Michel Dreyfus: SCLIN - Clinatec - Centre de recherche biomédicale Edmond J.Safra - CEA-LETI - Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information - DRT (CEA) - Direction de Recherche Technologique (CEA) - CEA - Commissariat à l'énergie atomique et aux énergies alternatives - CHUGA - Centre Hospitalier Universitaire [CHU Grenoble] - INSERM - Institut National de la Santé et de la Recherche Médicale - UGA [2016-2019] - Université Grenoble Alpes [2016-2019]
Corinne Dupont: SIS - Santé Individu Société - UL2 - Université Lumière - Lyon 2 - UJML - Université Jean Moulin - Lyon 3 - Université de Lyon - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - HCL - Hospices Civils de Lyon - UJM - Université Jean Monnet - Saint-Étienne - INSERM - Institut National de la Santé et de la Recherche Médicale, Réseau périnatal Aurore - Hôpital de la Croix-Rousse [CHU - HCL] - HCL - Hospices Civils de Lyon
Denis Gallot: Service de Gynécologie [CHU Clermont-Ferrand] - CHU Estaing [Clermont-Ferrand] - CHU Clermont-Ferrand, R2D2 - Retinoids, Development and Developmental Diseases - UdA - Université d'Auvergne - Clermont-Ferrand I
Jean-Baptiste Haumonté: Service d'Obstétrique-Gynécologie [Marseille] - APHM - Assistance Publique - Hôpitaux de Marseille - CHU Marseille - Hôpital Nord [CHU - APHM]
Cyril Huissoud: SBRI - Institut cellule souche et cerveau / Stem Cell and Brain Research Institute - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - INSERM - Institut National de la Santé et de la Recherche Médicale - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement
Gilles Kayem: CRESS - U1153 - Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique - UPD5 - Université Paris Descartes - Paris 5 - CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité - INRA - Institut National de la Recherche Agronomique - UPD7 - Université Paris Diderot - Paris 7 - UPD5 - Université Paris Descartes - Paris 5 - USPC - Université Sorbonne Paris Cité - INSERM - Institut National de la Santé et de la Recherche Médicale, CHU Trousseau [APHP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université
Hawa Keïta: Service d'Anesthésie-Réanimation - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - UPD7 - Université Paris Diderot - Paris 7 - Hôpital Beaujon [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Bruno Langer: Service de gynécologie–obstétrique - CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg] - HUS - Les Hôpitaux Universitaires de Strasbourg - Hôpital de Hautepierre [Strasbourg]
Olivier Morel: NanoRegMed - Nanomédecine Régénérative - UNISTRA - Université de Strasbourg - INSERM - Institut National de la Santé et de la Recherche Médicale
Olivier Parant: LEASP - Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale, Service Gynécologie [CHU Toulouse] - Pôle Femme-Mère-Couple [CHU Toulouse] - CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
Jean-Pierre Pelage: Hôpital Ambroise Paré, Department of Interventional Radiology - Assistance Publique - Hôpitaux de Paris
Mathias Rossignol: STMS - Sciences et Technologies de la Musique et du Son - IRCAM - Institut de Recherche et Coordination Acoustique/Musique - UPMC - Université Pierre et Marie Curie - Paris 6 - CNRS - Centre National de la Recherche Scientifique
Véronique Tessier: Réseau périnatal port-royal - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Saint-Vincent de Paul
François Goffinet: Service de Gynécologie et Obstétrique [Cochin] - Hôpital Cochin [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP), CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité - INRA - Institut National de la Recherche Agronomique - UPD7 - Université Paris Diderot - Paris 7 - UPD5 - Université Paris Descartes - Paris 5 - USPC - Université Sorbonne Paris Cité - INSERM - Institut National de la Santé et de la Recherche Médicale

Post-Print from HAL

Abstract: Postpartum haemorrhage (PPH) is defined as blood loss >= 500 mL after ă delivery and severe PPH as blood loss >= 1000 mL, regardless of the ă route of delivery (professional consensus). The preventive ă administration of uterotonic agents just after delivery is effective in ă reducing the incidence of PPH and its systematic use is recommended, ă regardless of the route of delivery (Grade A). Oxytocin is the first ă line prophylactic drug, regardless of the route of delivery (Grade A); a ă slowly dose of 5 or 10 IU can be administered (Grade A) either IV or IM ă (professional consensus).After vaginal delivery, routine cord drainage ă (Grade B), controlled cord traction (Grade A), uterine massage (Grade ă A), and routine bladder voiding (professional consensus) are not ă systematically recommended for PPH prevention. After caesarean delivery, ă placental delivery by controlled cord traction is recommended (grade B). ă The routine use of a collector bag to assess postpartum blood loss at ă vaginal delivery is not systematically recommended (Grade B), since the ă incidence of severe PPH is not affected by this intervention. In cases ă of overt PPH after vaginal delivery, placement of a blood collection bag ă is recommended (professional consensus). The initial treatment of PPH ă consists in a manual uterine examination, together with antibiotic ă prophylaxis, careful visual assessment of the lower genital tract, a ă uterine massage, and the administration of 5-10 IU oxytocin injected ă slowly IV or IM, followed by a maintenance infusion not to exceed a ă cumulative dose of 40 IU (professional consensus). If oxytocin fails to ă control the bleeding, the administration of sulprostone is recommended ă within 30 minutes of the PPH diagnosis (Grade C). Intrauterine balloon ă tamponade can be performed if sulprostone fails and before recourse to ă either surgery or interventional radiology (professional consensus). ă Fluid resuscitation is recommended for PPH persistent after first line ă uterotonics, or if clinical signs of severity (Grade B). The objective ă of RBC transfusion is to maintain a haemoglobin concentration (Hb) >8 ă g/dL. During active haemorrhaging, it is desirable to maintain a ă fibrinogen level >= 2 g/L (professional consensus). RBC, fibrinogen and ă fresh frozen plasma (FFP) may be administered without awaiting ă laboratory results (professional consensus). Tranexamic acid may be used ă at a dose of 1 g, renewable once if ineffective the first time in the ă treatment of PPH when bleeding persists after sulprostone administration ă (professional consensus), even though its clinical value has not yet ă been demonstrated in obstetric settings. It is recommended to prevent ă and treat hypothermia in women with PPH by warming infusion solutions ă and blood products and by active skin warming (Grade C). Oxygen ă administration is recommended in women with severe PPH (professional ă consensus). If PPH is not controlled by pharmacological treatments and ă possibly intra-uterine balloon, invasive treatments by arterial ă embolization or surgery are recommended (Grade C). No technique for ă conservative surgery is favoured over any other (professional ă consensus). Hospital-to-hospital transfer of a woman with a PPH for ă embolization is possible once hemoperitoneum is ruled out and if the ă patient's hemodynamic condition so allows (professional consensus). (C) ă 2015 Elsevier Ireland Ltd. All rights reserved.

Keywords: Quality; of; Life (search for similar items in EconPapers)
Date: 2016-03
References: Add references at CitEc
Citations:

Published in European Journal of Obstetrics & Gynecology and Reproductive Biology, 2016, 198, pp.12-21. ⟨10.1016/j.ejogrb.2015.12.012⟩

There are no downloads for this item, see the EconPapers FAQ for hints about obtaining it.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01482637

DOI: 10.1016/j.ejogrb.2015.12.012

Access Statistics for this paper

More papers in Post-Print from HAL
Bibliographic data for series maintained by CCSD ().