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Ronenson A.M.

E.M. Bakunina Tver Regional Clinical Perinatal Center, Tver, Russia, 170036

Shifman E.M.

M.F. Vladimirsky Moscow Regional Research Clinical Institute, Ministry of Health of the Moscow Region, Moscow, Russia

Kulikov A.V.

Infusion therapy strategy for postpartum hemorrhage: what guidelines to choose?

Authors:

Ronenson A.M., Shifman E.M., Kulikov A.V.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2018;(5): 15‑21

DOI: 10.17116/anaesthesiology201805115

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INFUSION THERAPY STRATEGY FOR POSTPARTUM HEMORRHAGE: WHAT GUIDELINES TO CHOOSE?
INFUSION THERAPY STRATEGY FOR POSTPARTUM HEMORRHAGE: WHAT GUIDELINES TO CHOOSE?

To cite this article:

Ronenson AM, Shifman EM, Kulikov AV. Infusion therapy strategy for postpartum hemorrhage: what guidelines to choose? Russian Journal of Anesthesiology and Reanimatology. 2018;(5):15‑21. (In Russ.)
https://doi.org/10.17116/anaesthesiology201805115

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What is a «normal» blood loss after childbirth? The usual «normal» volume of blood loss in labor and during cesarean section is not more than 500 and 1000 ml, respectively. However, such a volume of blood loss is a generalized one and cannot assess parturient woman’s or puerperant’s need for infusion therapy on an individual basis. «Normal limits» can be a fairly broad concept in assessing postpartum hemorrhage, because all women in labor have different blood volume status. The same amount of blood loss after childbirth can have a completely different effect on the condition and hemodynamic parameters of a certain parturient woman. The article discusses how to assess changes in the blood volume status of women in postpartum hemorrhage, how to correctly estimate the amount of blood loss and which guidelines are most significant. What should a doctor rely on when assessing the state of the mother who has postpartum bleeding intraoperatively and in the postpartum period? Particular attention is paid to monitoring of the obstetric shock index dynamics, as one of the simplest and at the same time informative indicators of evaluation of the status of the parturient woman with postpartum hemorrhage. Problems of an estimation of a need for infusion therapy in an obstetrical bleeding by means of non-invasive methods of estimation of the blood volume status are considered. After all, excessive massive infusion therapy, which is based only on empirical calculations, can often do more harm than good by enhancing the dilution coagulopathy. Therefore, new, more sophisticated methods of assessing the blood volume status of parturient women are required in assessing the need for infusion therapy.

Keywords:

postportum hemorrhage
infusion therapy in an obstetrocal bleeding

Authors:

Ronenson A.M.

E.M. Bakunina Tver Regional Clinical Perinatal Center, Tver, Russia, 170036

Shifman E.M.

M.F. Vladimirsky Moscow Regional Research Clinical Institute, Ministry of Health of the Moscow Region, Moscow, Russia

Kulikov A.V.

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