ANESTHESTIC MANAGEMENT OF POSTPARTUM HEMORRHAGE
Djoni Kusumah Himsani Pohan

Medical Faculty, Universitas Jenderal Achmad Yani

Abstract

Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality in the world. It requires a higher level of standard care. Peripartum hemorrhage is bleeding that occurs during pregnancy (antepartum), at birth (intrapartum) and after birth (postpartum). Management of postpartum hemorrhage should be done with multidisciplinary approach including determining the cause of PPH, close observation of vital signs, and intravenous access with a minimum of one large bore. Hemodynamic condition should be stabilized first.
In 2020, WHO officially stated COVID-19 as a pandemic which requires the use of suitable Personal Protective Equipment (PPE) depending on the condition. When the diagnosis of PPH is made, prompt resuscitation with administration of crystalloid, colloid, oxygen therapy, and protection against hypothermia, obtaining initial blood sample. Pharmacological therapy includes oxytocin IV or IM, sulproston and carboprost as the effective and recommended drugs. Blood transfusion is required.

Keywords: anesthetic managements, covid-19, obstetric anesthesia, postpartum hemorrhage

Topic: Clinical Practice in Pandemic Era