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Practice Guideline
. 2019 Mar;17(2):112-136.
doi: 10.2450/2019.0245-18. Epub 2019 Feb 6.

Patient blood management in obstetrics: prevention and treatment of postpartum haemorrhage. A NATA consensus statement

Manuel Muñoz  1   2 , Jakob Stensballe  2   3 , Anne-Sophie Ducloy-Bouthors  4 , Marie-Pierre Bonnet  5 , Edoardo De Robertis  6   7 , Ino Fornet  8 , François Goffinet  9 , Stefan Hofer  10 , Wolfgang Holzgreve  11   12 , Susana Manrique  13 , Jacky Nizard  14   15 , François Christory  2 , Charles-Marc Samama  5   2 , Jean-François Hardy  16   2
Affiliations
Practice Guideline

Patient blood management in obstetrics: prevention and treatment of postpartum haemorrhage. A NATA consensus statement

Manuel Muñoz et al. Blood Transfus. 2019 Mar.

Abstract

Patient blood management (PBM) is the timely application of evidence-informed medical and surgical concepts designed to maintain haemoglobin concentration, optimise haemostasis, and minimise blood loss in an effort to improve patient outcomes. The aim of this consensus statement is to provide recommendations on the prevention and treatment of postpartum haemorrhage as part of PBM in obstetrics. A multidisciplinary panel of physicians with expertise in obstetrics, anaesthesia, haematology, and transfusion medicine was convened by the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA) in collaboration with the International Federation of Gynaecology and Obstetrics (FIGO), the European Board and College of Obstetrics and Gynaecology (EBCOG), and the European Society of Anaesthesiology (ESA). Members of the task force assessed the quantity, quality and consistency of the published evidence, and formulated recommendations using the system developed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group. The recommendations in this consensus statement are intended for use by clinical practitioners managing perinatal care of women in all settings, and by policy-makers in charge of decision making for the update of clinical practice in health care establishments.

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Conflict of interest statement

Disclosure of conflicts of interest

ASD-B has received consulting fees and research support from LFB. IF has received travel support for congress attendance and/or financial support for educational activities from Vifor Pharma, Fresenius Kabi and CSL Behring. MM has received funding for consultancies, lectures and/or travel from Vifor Pharma, Wellspect HealthCare, Pharmacosmos, Ferrer Pharma, CSL Behring, PharmaNutra and Zambon. SH has received speaker fees and consulting fees from CSL Behring and speaker fees from Vifor Pharma. CMS has received consulting fees from LFB and Octapharma. The other Authors have reported no conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
The grading system used to evaluate the quality of the evidence and grade recommendations.
Figure 2
Figure 2
Quick reference guide for the management of postpartum haemorrhage. ICU: intensive care unit; LAB: central laboratory; POC: point-of-care; BP: blood pressure; HR: heart rate; RBC: red blood cell; PPH: postpartum haemorrhage; TEG: thromboelastography; ROTEM: rotational thromboelastometry.
Figure 3
Figure 3
An example of the postpartum haemorrhage chart. HR: heart rate; BP: blood pressure; RR: respiratory rate; Lab: central laboratory; POC: point-of-care; PGF2: prostaglandin F2; PRBC: packed red blood cells; rFVIIa: recombinant activated factor VII; E.V.A.: expiratory ventilation assistance; LA: local anaesthetic; LDH: lactate dehydrogenase.
See this image and copyright information in PMC

Comment in

References

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