TITLE:
A Survey of Current Treatment Practices for Postpartum Hemorrhage by Practicing Obstetricians and Hematologists
AUTHORS:
Elizabeth W. Triche, Mark J. Wehrum, Michael J. Paidas
KEYWORDS:
Postpartum Hemorrhage; Physician Survey; Recombinant Factor VIIa; Clinical Management
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.6,
April
15,
2014
ABSTRACT: Objective: To identify
current treatment strategies for postpartum hemorrhage used by obstetricians
(OB/GYNs) and hematologists (HEMs). Study Design: We conducted a survey of
OB/GYNs (n = 220) and HEMs
(n = 30) to describe the
characteristics of current treatment strategies for postpartum hemorrhage.
Surveys were administered via a structured questionnaire on a secure internet
website from 5 - 12 October 2009. Results: The majority of OB/GYN and HEM
respondents were practicing in a community hospital environment (77%). Of the
OB/GYNs, the majority practiced at hospitals with over 2000 deliveries per year
(77%). A majority (58%) of OB/GYNs were affiliated with hospitals that lacked a
massive transfusion protocol to treat severe postpartum hemorrhage. Subsequent
to uterine massage and additional oxytocin, the majority of OB/GYNs (73%),
preferred the administration of Methergine? as the next level of intervention for
postpartum hemorrhage. There was considerable variability in response to
specific treatment strategies for several hypothetical case scenarios; however,
the large majority of OB/GYNs favored obstetrical procedures over
interventional radiology or administration of rFVIIa. A large majority (77%) of
physicians who are familiar with rRVIIa as treatment for postpartum hemorrhage
reported being very satisfied with the agent for this indication. Conclusions:
An established, systematic treatment strategy among OB/GYNs emerged only in the
case of mild postpartum hemorrhage.