Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consens...
- Autores
- Pingray, Verónica; Williams, Caitlin R; Alwy Al-beity, Fadhlun M.; Abalos, Edgardo; Arulkumaran, Sabaratnam; Blumenfeld, Alejandro; Carvalho, Brendan; Deneux Tharaux, Catherine; Downe, Soo; Dumont, Alexandre; Escobar, Maria Fernanda; Evans, Cherrie; Fawcus, Sue; Galadanci, Hadiza S.; Hoang, Diem Tuyet Thi; Hofmeyr Justus, G.; Homer, Caroline; Lewis, Ayodele G.; Liabsuetrakul, Tippawan; Lumbiganon, Pisake; Main, Elliott K; Maua, Judith; Muriithi, Francis G.; Nabhan, Ashraf Fawzy; Nunes, Inês; Ortega, Vanesa; Phan, Thuan N Q; Qureshi, Zahida P.; Sosa, Claudio; Varallo, John; Weeks, Andrew D.; Widmer, Mariana; Oladapo, Olufemi T.; Gallos, Ioannis; Coomarasamy, Arri; Miller, Suellen; Althabe, Fernando
- Año de publicación
- 2024
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert´s consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth.Design: Systematic review and three-stage modified Delphi expert consensus.Setting: International.Population: Panel of 22 global experts in PPH with diverse backgrounds, and gender, professional and geographic balance.Outcome measures: Agreement or disagreement on strategies for early detection and first response management of PPH at caesarean birth.Results: Experts agreed that the same PPH definition should apply to both vaginal and caesarean birth. For the intraoperative phase, the experts agreed that early detection should be accomplished via quantitative blood loss measurement, complemented by monitoring the woman´s haemodynamic status; and that first response should be triggered once the woman loses at least 500 mL of blood with continued bleeding or when she exhibits clinical signs of haemodynamic instability, whichever occurs first. For the first response, experts agreed on immediate administration of uterotonics and tranexamic acid, examination to determine aetiology and rapid initiation of cause-specific responses. In the postoperative phase, the experts agreed that caesarean birth-related PPH should be detected primarily via frequently monitoring the woman´s haemodynamic status and clinical signs and symptoms of internal bleeding, supplemented by cumulative blood loss assessment performed quantitatively or by visual estimation. Postoperative first response was determined to require an individualised approach.Conclusion: These agreed on proposed approaches could help improve the detection of PPH in the intraoperative and postoperative phases of caesarean birth and the first response management of intraoperative PPH. Determining how best to implement these strategies is a critical next step.
Fil: Pingray, Verónica. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Williams, Caitlin R. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Alwy Al-beity, Fadhlun M.. Muhimbili University of Health and Allied Sciences; Tanzania
Fil: Abalos, Edgardo. No especifíca;
Fil: Arulkumaran, Sabaratnam. St George's Hospital; Reino Unido
Fil: Blumenfeld, Alejandro. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Carvalho, Brendan. Stanford University School Of Medicine; Estados Unidos
Fil: Deneux Tharaux, Catherine. Universite de Paris; Francia
Fil: Downe, Soo. University Of Central Lancashire; Reino Unido
Fil: Dumont, Alexandre. Universite de Paris; Francia
Fil: Escobar, Maria Fernanda. Universite de Paris. Umr - S1134 Biologie Integree Du Globule Rouge;
Fil: Evans, Cherrie. No especifíca;
Fil: Fawcus, Sue. University of Cape Town; Sudáfrica
Fil: Galadanci, Hadiza S.. Aminu Kano Teaching Hospital; Nigeria
Fil: Hoang, Diem Tuyet Thi. Hung Vuong Hospital; Vietnam
Fil: Hofmeyr Justus, G.. University Of Botswana; Botsuana
Fil: Homer, Caroline. Burnet Institute; Australia
Fil: Lewis, Ayodele G.. Amherst College; Estados Unidos
Fil: Liabsuetrakul, Tippawan. Prince Of Songkla University; Tailandia
Fil: Lumbiganon, Pisake. Khon Kaen University; Tailandia
Fil: Main, Elliott K. University of Stanford; Estados Unidos
Fil: Maua, Judith. Liverpool School Of Tropical Medicine; Kenia
Fil: Muriithi, Francis G.. University Of Birmingham; Reino Unido
Fil: Nabhan, Ashraf Fawzy. Ain Shams University Faculty Of Medicine; Egipto
Fil: Nunes, Inês. No especifíca;
Fil: Ortega, Vanesa. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Phan, Thuan N Q. University of Liverpool; Reino Unido
Fil: Qureshi, Zahida P.. University Of Nairobi; Kenia
Fil: Sosa, Claudio. Pan American Health Organization; Estados Unidos
Fil: Varallo, John. Global Surgery Foundation; Estados Unidos
Fil: Weeks, Andrew D.. University of Liverpool; Reino Unido
Fil: Widmer, Mariana. Organizacion Mundial de la Salud; Argentina
Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; Argentina
Fil: Gallos, Ioannis. Organizacion Mundial de la Salud; Argentina
Fil: Coomarasamy, Arri. University Of Birmingham;
Fil: Miller, Suellen. University Of California San Francisco; Estados Unidos
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina - Materia
-
CLINICAL DECISION-MAKING
MATERNAL MEDICINE
OBSTETRICS
POSTPARTUM PERIOD
SYSTEMATIC REVIEW - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by/2.5/ar/
- Repositorio
.jpg)
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/291092
Ver los metadatos del registro completo
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Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensusPingray, VerónicaWilliams, Caitlin RAlwy Al-beity, Fadhlun M.Abalos, EdgardoArulkumaran, SabaratnamBlumenfeld, AlejandroCarvalho, BrendanDeneux Tharaux, CatherineDowne, SooDumont, AlexandreEscobar, Maria FernandaEvans, CherrieFawcus, SueGaladanci, Hadiza S.Hoang, Diem Tuyet ThiHofmeyr Justus, G.Homer, CarolineLewis, Ayodele G.Liabsuetrakul, TippawanLumbiganon, PisakeMain, Elliott KMaua, JudithMuriithi, Francis G.Nabhan, Ashraf FawzyNunes, InêsOrtega, VanesaPhan, Thuan N QQureshi, Zahida P.Sosa, ClaudioVarallo, JohnWeeks, Andrew D.Widmer, MarianaOladapo, Olufemi T.Gallos, IoannisCoomarasamy, ArriMiller, SuellenAlthabe, FernandoCLINICAL DECISION-MAKINGMATERNAL MEDICINEOBSTETRICSPOSTPARTUM PERIODSYSTEMATIC REVIEWhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert´s consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth.Design: Systematic review and three-stage modified Delphi expert consensus.Setting: International.Population: Panel of 22 global experts in PPH with diverse backgrounds, and gender, professional and geographic balance.Outcome measures: Agreement or disagreement on strategies for early detection and first response management of PPH at caesarean birth.Results: Experts agreed that the same PPH definition should apply to both vaginal and caesarean birth. For the intraoperative phase, the experts agreed that early detection should be accomplished via quantitative blood loss measurement, complemented by monitoring the woman´s haemodynamic status; and that first response should be triggered once the woman loses at least 500 mL of blood with continued bleeding or when she exhibits clinical signs of haemodynamic instability, whichever occurs first. For the first response, experts agreed on immediate administration of uterotonics and tranexamic acid, examination to determine aetiology and rapid initiation of cause-specific responses. In the postoperative phase, the experts agreed that caesarean birth-related PPH should be detected primarily via frequently monitoring the woman´s haemodynamic status and clinical signs and symptoms of internal bleeding, supplemented by cumulative blood loss assessment performed quantitatively or by visual estimation. Postoperative first response was determined to require an individualised approach.Conclusion: These agreed on proposed approaches could help improve the detection of PPH in the intraoperative and postoperative phases of caesarean birth and the first response management of intraoperative PPH. Determining how best to implement these strategies is a critical next step.Fil: Pingray, Verónica. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Williams, Caitlin R. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Alwy Al-beity, Fadhlun M.. Muhimbili University of Health and Allied Sciences; TanzaniaFil: Abalos, Edgardo. No especifíca;Fil: Arulkumaran, Sabaratnam. St George's Hospital; Reino UnidoFil: Blumenfeld, Alejandro. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Carvalho, Brendan. Stanford University School Of Medicine; Estados UnidosFil: Deneux Tharaux, Catherine. Universite de Paris; FranciaFil: Downe, Soo. University Of Central Lancashire; Reino UnidoFil: Dumont, Alexandre. Universite de Paris; FranciaFil: Escobar, Maria Fernanda. Universite de Paris. Umr - S1134 Biologie Integree Du Globule Rouge;Fil: Evans, Cherrie. No especifíca;Fil: Fawcus, Sue. University of Cape Town; SudáfricaFil: Galadanci, Hadiza S.. Aminu Kano Teaching Hospital; NigeriaFil: Hoang, Diem Tuyet Thi. Hung Vuong Hospital; VietnamFil: Hofmeyr Justus, G.. University Of Botswana; BotsuanaFil: Homer, Caroline. Burnet Institute; AustraliaFil: Lewis, Ayodele G.. Amherst College; Estados UnidosFil: Liabsuetrakul, Tippawan. Prince Of Songkla University; TailandiaFil: Lumbiganon, Pisake. Khon Kaen University; TailandiaFil: Main, Elliott K. University of Stanford; Estados UnidosFil: Maua, Judith. Liverpool School Of Tropical Medicine; KeniaFil: Muriithi, Francis G.. University Of Birmingham; Reino UnidoFil: Nabhan, Ashraf Fawzy. Ain Shams University Faculty Of Medicine; EgiptoFil: Nunes, Inês. No especifíca;Fil: Ortega, Vanesa. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Phan, Thuan N Q. University of Liverpool; Reino UnidoFil: Qureshi, Zahida P.. University Of Nairobi; KeniaFil: Sosa, Claudio. Pan American Health Organization; Estados UnidosFil: Varallo, John. Global Surgery Foundation; Estados UnidosFil: Weeks, Andrew D.. University of Liverpool; Reino UnidoFil: Widmer, Mariana. Organizacion Mundial de la Salud; ArgentinaFil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; ArgentinaFil: Gallos, Ioannis. Organizacion Mundial de la Salud; ArgentinaFil: Coomarasamy, Arri. University Of Birmingham;Fil: Miller, Suellen. University Of California San Francisco; Estados UnidosFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaBMJ Publishing2024-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/291092Pingray, Verónica; Williams, Caitlin R; Alwy Al-beity, Fadhlun M.; Abalos, Edgardo; Arulkumaran, Sabaratnam; et al.; Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus; BMJ Publishing; BMJ Open; 14; 5; 5-2024; 1-122044-6055CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2023-079713info:eu-repo/semantics/altIdentifier/doi/10.1136/bmjopen-2023-079713info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:43:03Zoai:ri.conicet.gov.ar:11336/291092instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:43:03.856CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
| dc.title.none.fl_str_mv |
Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title |
Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| spellingShingle |
Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus Pingray, Verónica CLINICAL DECISION-MAKING MATERNAL MEDICINE OBSTETRICS POSTPARTUM PERIOD SYSTEMATIC REVIEW |
| title_short |
Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_full |
Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_fullStr |
Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_full_unstemmed |
Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_sort |
Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| dc.creator.none.fl_str_mv |
Pingray, Verónica Williams, Caitlin R Alwy Al-beity, Fadhlun M. Abalos, Edgardo Arulkumaran, Sabaratnam Blumenfeld, Alejandro Carvalho, Brendan Deneux Tharaux, Catherine Downe, Soo Dumont, Alexandre Escobar, Maria Fernanda Evans, Cherrie Fawcus, Sue Galadanci, Hadiza S. Hoang, Diem Tuyet Thi Hofmeyr Justus, G. Homer, Caroline Lewis, Ayodele G. Liabsuetrakul, Tippawan Lumbiganon, Pisake Main, Elliott K Maua, Judith Muriithi, Francis G. Nabhan, Ashraf Fawzy Nunes, Inês Ortega, Vanesa Phan, Thuan N Q Qureshi, Zahida P. Sosa, Claudio Varallo, John Weeks, Andrew D. Widmer, Mariana Oladapo, Olufemi T. Gallos, Ioannis Coomarasamy, Arri Miller, Suellen Althabe, Fernando |
| author |
Pingray, Verónica |
| author_facet |
Pingray, Verónica Williams, Caitlin R Alwy Al-beity, Fadhlun M. Abalos, Edgardo Arulkumaran, Sabaratnam Blumenfeld, Alejandro Carvalho, Brendan Deneux Tharaux, Catherine Downe, Soo Dumont, Alexandre Escobar, Maria Fernanda Evans, Cherrie Fawcus, Sue Galadanci, Hadiza S. Hoang, Diem Tuyet Thi Hofmeyr Justus, G. Homer, Caroline Lewis, Ayodele G. Liabsuetrakul, Tippawan Lumbiganon, Pisake Main, Elliott K Maua, Judith Muriithi, Francis G. Nabhan, Ashraf Fawzy Nunes, Inês Ortega, Vanesa Phan, Thuan N Q Qureshi, Zahida P. Sosa, Claudio Varallo, John Weeks, Andrew D. Widmer, Mariana Oladapo, Olufemi T. Gallos, Ioannis Coomarasamy, Arri Miller, Suellen Althabe, Fernando |
| author_role |
author |
| author2 |
Williams, Caitlin R Alwy Al-beity, Fadhlun M. Abalos, Edgardo Arulkumaran, Sabaratnam Blumenfeld, Alejandro Carvalho, Brendan Deneux Tharaux, Catherine Downe, Soo Dumont, Alexandre Escobar, Maria Fernanda Evans, Cherrie Fawcus, Sue Galadanci, Hadiza S. Hoang, Diem Tuyet Thi Hofmeyr Justus, G. Homer, Caroline Lewis, Ayodele G. Liabsuetrakul, Tippawan Lumbiganon, Pisake Main, Elliott K Maua, Judith Muriithi, Francis G. Nabhan, Ashraf Fawzy Nunes, Inês Ortega, Vanesa Phan, Thuan N Q Qureshi, Zahida P. Sosa, Claudio Varallo, John Weeks, Andrew D. Widmer, Mariana Oladapo, Olufemi T. Gallos, Ioannis Coomarasamy, Arri Miller, Suellen Althabe, Fernando |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
CLINICAL DECISION-MAKING MATERNAL MEDICINE OBSTETRICS POSTPARTUM PERIOD SYSTEMATIC REVIEW |
| topic |
CLINICAL DECISION-MAKING MATERNAL MEDICINE OBSTETRICS POSTPARTUM PERIOD SYSTEMATIC REVIEW |
| purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.3 https://purl.org/becyt/ford/3 |
| dc.description.none.fl_txt_mv |
Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert´s consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth.Design: Systematic review and three-stage modified Delphi expert consensus.Setting: International.Population: Panel of 22 global experts in PPH with diverse backgrounds, and gender, professional and geographic balance.Outcome measures: Agreement or disagreement on strategies for early detection and first response management of PPH at caesarean birth.Results: Experts agreed that the same PPH definition should apply to both vaginal and caesarean birth. For the intraoperative phase, the experts agreed that early detection should be accomplished via quantitative blood loss measurement, complemented by monitoring the woman´s haemodynamic status; and that first response should be triggered once the woman loses at least 500 mL of blood with continued bleeding or when she exhibits clinical signs of haemodynamic instability, whichever occurs first. For the first response, experts agreed on immediate administration of uterotonics and tranexamic acid, examination to determine aetiology and rapid initiation of cause-specific responses. In the postoperative phase, the experts agreed that caesarean birth-related PPH should be detected primarily via frequently monitoring the woman´s haemodynamic status and clinical signs and symptoms of internal bleeding, supplemented by cumulative blood loss assessment performed quantitatively or by visual estimation. Postoperative first response was determined to require an individualised approach.Conclusion: These agreed on proposed approaches could help improve the detection of PPH in the intraoperative and postoperative phases of caesarean birth and the first response management of intraoperative PPH. Determining how best to implement these strategies is a critical next step. Fil: Pingray, Verónica. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Williams, Caitlin R. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Alwy Al-beity, Fadhlun M.. Muhimbili University of Health and Allied Sciences; Tanzania Fil: Abalos, Edgardo. No especifíca; Fil: Arulkumaran, Sabaratnam. St George's Hospital; Reino Unido Fil: Blumenfeld, Alejandro. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Carvalho, Brendan. Stanford University School Of Medicine; Estados Unidos Fil: Deneux Tharaux, Catherine. Universite de Paris; Francia Fil: Downe, Soo. University Of Central Lancashire; Reino Unido Fil: Dumont, Alexandre. Universite de Paris; Francia Fil: Escobar, Maria Fernanda. Universite de Paris. Umr - S1134 Biologie Integree Du Globule Rouge; Fil: Evans, Cherrie. No especifíca; Fil: Fawcus, Sue. University of Cape Town; Sudáfrica Fil: Galadanci, Hadiza S.. Aminu Kano Teaching Hospital; Nigeria Fil: Hoang, Diem Tuyet Thi. Hung Vuong Hospital; Vietnam Fil: Hofmeyr Justus, G.. University Of Botswana; Botsuana Fil: Homer, Caroline. Burnet Institute; Australia Fil: Lewis, Ayodele G.. Amherst College; Estados Unidos Fil: Liabsuetrakul, Tippawan. Prince Of Songkla University; Tailandia Fil: Lumbiganon, Pisake. Khon Kaen University; Tailandia Fil: Main, Elliott K. University of Stanford; Estados Unidos Fil: Maua, Judith. Liverpool School Of Tropical Medicine; Kenia Fil: Muriithi, Francis G.. University Of Birmingham; Reino Unido Fil: Nabhan, Ashraf Fawzy. Ain Shams University Faculty Of Medicine; Egipto Fil: Nunes, Inês. No especifíca; Fil: Ortega, Vanesa. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Phan, Thuan N Q. University of Liverpool; Reino Unido Fil: Qureshi, Zahida P.. University Of Nairobi; Kenia Fil: Sosa, Claudio. Pan American Health Organization; Estados Unidos Fil: Varallo, John. Global Surgery Foundation; Estados Unidos Fil: Weeks, Andrew D.. University of Liverpool; Reino Unido Fil: Widmer, Mariana. Organizacion Mundial de la Salud; Argentina Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; Argentina Fil: Gallos, Ioannis. Organizacion Mundial de la Salud; Argentina Fil: Coomarasamy, Arri. University Of Birmingham; Fil: Miller, Suellen. University Of California San Francisco; Estados Unidos Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina |
| description |
Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert´s consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth.Design: Systematic review and three-stage modified Delphi expert consensus.Setting: International.Population: Panel of 22 global experts in PPH with diverse backgrounds, and gender, professional and geographic balance.Outcome measures: Agreement or disagreement on strategies for early detection and first response management of PPH at caesarean birth.Results: Experts agreed that the same PPH definition should apply to both vaginal and caesarean birth. For the intraoperative phase, the experts agreed that early detection should be accomplished via quantitative blood loss measurement, complemented by monitoring the woman´s haemodynamic status; and that first response should be triggered once the woman loses at least 500 mL of blood with continued bleeding or when she exhibits clinical signs of haemodynamic instability, whichever occurs first. For the first response, experts agreed on immediate administration of uterotonics and tranexamic acid, examination to determine aetiology and rapid initiation of cause-specific responses. In the postoperative phase, the experts agreed that caesarean birth-related PPH should be detected primarily via frequently monitoring the woman´s haemodynamic status and clinical signs and symptoms of internal bleeding, supplemented by cumulative blood loss assessment performed quantitatively or by visual estimation. Postoperative first response was determined to require an individualised approach.Conclusion: These agreed on proposed approaches could help improve the detection of PPH in the intraoperative and postoperative phases of caesarean birth and the first response management of intraoperative PPH. Determining how best to implement these strategies is a critical next step. |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2024-05 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
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article |
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http://hdl.handle.net/11336/291092 Pingray, Verónica; Williams, Caitlin R; Alwy Al-beity, Fadhlun M.; Abalos, Edgardo; Arulkumaran, Sabaratnam; et al.; Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus; BMJ Publishing; BMJ Open; 14; 5; 5-2024; 1-12 2044-6055 CONICET Digital CONICET |
| url |
http://hdl.handle.net/11336/291092 |
| identifier_str_mv |
Pingray, Verónica; Williams, Caitlin R; Alwy Al-beity, Fadhlun M.; Abalos, Edgardo; Arulkumaran, Sabaratnam; et al.; Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus; BMJ Publishing; BMJ Open; 14; 5; 5-2024; 1-12 2044-6055 CONICET Digital CONICET |
| dc.language.none.fl_str_mv |
eng |
| language |
eng |
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info:eu-repo/semantics/altIdentifier/url/https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2023-079713 info:eu-repo/semantics/altIdentifier/doi/10.1136/bmjopen-2023-079713 |
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info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/2.5/ar/ |
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openAccess |
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application/pdf application/pdf |
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BMJ Publishing |
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BMJ Publishing |
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Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
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dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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