STEPWISE MANAGEMENT OF OBSTETRIC HEMORRHAGE IN THE EARLY POSTPARTUM PERIOD: A PRACTICAL ALGORITHM AND CONTEMPORARY RECOMMENDATIONS
Keywords:
early postpartum hemorrhage; massive blood loss; protocol; tranexamic acid; balloon tamponade; B-Lynch; coagulopathy.Abstract
Obstetric hemorrhage remains one of the leading preventable causes of maternal mortality and severe maternal morbidity. Key contributors to adverse outcomes include delayed recognition of increasing blood loss, delayed team response, insufficient uterotonic therapy, and late initiation of hemostatic resuscitation. This paper aims to systematize a stepwise algorithm for the management of early postpartum hemorrhage (PPH), with emphasis on the first 20 minutes when clinical outcomes are often determined, and to present practical tactical pathways for refractory bleeding.
A narrative review of clinical guidelines and consensus statements (RCOG Green-top Guideline No. 52, ACOG Practice Bulletin No. 183, WHO recommendations on tranexamic acid, etc.) was conducted, and key elements of local emergency obstetric care protocols were summarized.
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