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Major obstetric haemorrhage 

Major obstetric haemorrhage
Major obstetric haemorrhage

Sue Catling

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date: 06 May 2021

Sue Catling

Definition, incidence and impact 434

Organizational aspects 436

Clinical management overview 438

Directed therapy 442

Blood transfusion and coagulation factors 446

New innovations 450

Anaesthesia 452

Continuing care 454

The CEMACH reports that 14 women in the UK died directly from obstetric haemorrhage in the period 2003–2005, i.e. 6.6 deaths per million maternities. Haemorrhage is the third most common cause of direct maternal deaths after thromboembolism, and pre-eclampsia. It is salutary to realize that not only is the current death rate more than twice that of the triennium 1997–1999, when there were 7 deaths, i.e. 3.3 deaths per million maternities, but the latest figures have returned to that of 20 years ago. CEMACH also highlights that 58% of the deaths involved ‘substandard care’—these women may well have survived with optimal management....

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