Obstetrical Hemorrhage Review

Obstetrical hemorrhage is the leading cause of maternal mortality worldwide. Management of obstetrical hemorrhage involves medical knowledge and surgical skill. Uterotonics for the prevention and treatment of uterine atony remain the cornerstone of medical management. The rising rate of placenta accreta emphasizes the importance of definitive surgical management. Proficiency of uterinesparing techniques for the management of uterine atony or placenta accreta allow alternative options for those who wish to preserve fertility. New concepts in the management of severe obstetrical hemorrhage have changed how we care for this unique emergent condition. The use of massive transfusion protocols in conjunction with products such as tranexamic acid, fibrinogen concentrates and prothrombin complex concentrates are emerging techniques to reduce morbidity and mortality.