Feature
The future of maternal care
The need for postpartum hemorrhage response teams By Janice M. Newsome, MD, FSIR
system in the case of an emergency. Like with any other equivalent trauma, when a patient begins to hemorrhage, there should be a built-in response team that can offer the patient the best care for her specific situation.
birth can quickly spiral into a dangerous one. Postpartum hemorrhaging (PPH) can occur during delivery or even days after and is one of the leading causes of maternal mortality during childbirth. Hysterectomies are the default treatment, and while they are sometimes the best or only choice, these invasive procedures introduce more trauma and difficulty onto the patient than may be necessary.
B 12 IRQ | SUMMER 2021
irth is a maddening time. It’s emotional, stressful and messy—and when a patient begins to bleed, an easy
Uterine artery embolization (UAE) is a proven alternative to hysterectomy in many cases, and its minimally invasive nature can decrease the morbidities and costs associated with PPH, as well as preserve future fertility. But when an obstetrician is faced with a dangerous bleed that could lead to loss of life, it often seems faster and safer to conduct a hysterectomy, rather than take the perceived risk of waiting for an IR.
OBs shouldn’t have to weigh the risks of waiting for additional help, and mothers should be afforded a robust support
The need for a PPH response team IRs have seen the success of the pulmonary embolism response team (PERT) framework. The PERT model was born from the fact that a PE can rapidly kill a patient and requires a multidisciplinary approach to treatment. It took work to convince the relevant parties, but now when a person has a massive PE and is hemodynamically unstable, there is no question as to what to do. We have lifted the burden of personal responsibility off individual physicians and worked together to better treat a serious medical emergency, using the knowledge of other disciplines and the minimally invasive therapies of IR.
There is no reason why PPH should not be treated the same. However, there are questions and steps to be addressed before such a team could become effective.
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