American Journal of Obstetrics & Gynecology – Expert Review
Wolfgang Henrich, MD, PhD; Anna Du¨ckelmann, MD; Thorsten Braun, MD, PhD;
Larry Hinkson, MBBS, MD, MRCOG, FRCOG
Postpartum hemorrhage (PPH) causes substantial maternal mortality and morbidity and is responsible for a quarter of all maternal deaths worldwide.1 Conventional use of uterotonics such as oxytocin, prostaglandins, and medications to support coagulation, such as fibrinogen and tranexamic acid, are helpful but may not be sufficient to arrest life-threatening PPH. Blood transfusions, intrauterine balloon tamponade application, invasive techniques, such as compression sutures, and arterial ligation are advanced steps in the management cascade. In extreme cases, a hysterectomy may be necessary to avoid maternal death.