Antepartum and Postpartum Hemorrhage

Obstetric hemorrhage is among the leading causes and the most preventable cause, of maternal mortality. Hemorrhage can be divided into early (stage 1) to late stages (stage 3), depending on the amount of blood lost and vital sign changes. Etiologies include antepartum hemorrhage such as abnormal placentation and postpartum hemorrhage such as uterine atony and retained products of conception. Early recognition of ongoing hemorrhage based on risk factors, vital sign changes, and quantification of blood loss is essential to adequately resuscitate the patient. Obstetric hemorrhage emergency flowcharts and the use of point-of-care testing such as rotational thromboelastometry have been developed to guide clinicians in their resuscitative efforts and blood product use as hemorrhage progresses. This review contains 5 figures, 6 tables and 29 references Key Words: abnormal placentation, antepartum hemorrhage, blood products, massive hemorrhage, maternal early warning signs of hemorrhage, postpartum hemorrhage, rotational thromboelastometry, uterine atony