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KMID : 0614720070500121096
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Journal of Korean Medical Association
2007 Volume.50 No. 12 p.1096 ~ p.1106
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Management of Postpartum Hemorrhage
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Kim Ahm
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Abstract
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Despite recent improvements in the intensive care for postpartum hemorrhage, it remains one
of the leading causes of maternal mortality and morbidity for obstetricians. Because it is
difficult to prevent or predict postpartum hemorrhage, it is important to manage any such patients
correctly and promptly. Management of postpartum hemorrhage may vary greatly among
patients, depending on the etiology of the bleeding, available treatment options, and the patient’s
desire for future fertility. When managing postpartum hemorrhage, it is necessary to balance the
use of conservative management with the need to control the bleeding and achieve hemostasis.
Uterine massage and compression, and the administration of uterotonics such as oxytocin, ergometrine,
and prostaglandins are primary, conservative, and noninvasive management techniques
for patients with postpartum hemorrhage. Relatively noninvasive procedures such as curettage
of remnant tissues, vaginal packing, repair of laceration, and percutaneous angiographic embolization
can also be performed. In cases where these management techniques fail, surgical
alternatives such as uterine or internal iliac artery ligation, uterine compression sutures, or
hystrectomy are used. Surgical treatment of postpartum bleeding, performed as an appropriate
and timely intervention, is life-saving. The management of postpartum bleeding requires a
multidisciplinary approach with timely and efficient communication between clinical specialists and
preserving fertility.
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KEYWORD
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Postpartum hemorrhage, Medical management, Surgical management
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