• Sophie Nebout, Nadia Merbai, Valentina Faitot, and Hawa Keita.
• AP-HP, CHU Louis-Mourier, service d'anesthésie, université Paris 7, 92701 Colombes cedex, France.
• Presse Med. 2014 Feb 1;43(2):111-7.

AbstractPostpartum hemorrhage (PPH) is defined by loss of greater than 500 mL of blood following vaginal delivery or 1,000 mL of blood following cesarean section, in the first 24 hours postpartum. Its incidence is up to 5% and the severe forms represent 1% of births. PPH is the first cause of obstetrical maternal mortality in France and 90% of these deaths are considered as preventable. Its management is multidisciplinary (obstetricians, anesthetists, midwives, biologists and interventional radiologists), based on treatment protocols where time is a major prognosis factor. In case of failure of the initial measures (oxytocin, manual placenta removal, uterus and birth canal examination), the management of severe forms includes active resuscitation (intravenous fluids, blood transfusion, vasoactive drugs), haemostatic interventions (sulprostone, tamponnade and haemostatic suture, surgical procedures and arterial embolization) and the correction of any potential coagulopathy (administration of blood products and haemostatic agents).Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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