Prevention, the algorithm of reference, anesthesia and intensive care for postpartum hemorrhage. Guidelines

E.M. Shifman1, A.V. Kulikov2, A.M. Ronenson3, I.S. Abazova4, L.V. Adamyan5, M.D. Andreeva6, N.V. Artymuk7, O.R. Baev5, S.V. Barinov8, T.E. Belokrinitskaya9, S.I. Blauman10, I.V. Bratishchev11, A.A. Bukhtin12, V.Y. Vartanov13, A.B. Volkov14, V.S. Gorokhovskiy15, N.V. Dolgushina5, A.N. Drobinskaya16, S.V. Kinzhalova17, I.Z. Kitiashvili18, I.Yu. Kogan19, A.Yu. Korolev5, V.I. Krasnopolskii20, I.I. Kukarskaya21, M.A. Kurcer22, D.V. Marshalov23, A.A. Matkovskiy24, A.M. Ovezov1, G.A. Penzhoyan6, T.Yu. Pestrikova15, V.A. Petruhin20, A.M. Prihodko5, N.V. Protopopova25, D.N. Protsenko22, A.V. Pyregov5, Yu.S. Raspopin26, O.V. Rogachevskiy5, O.V. Ryazanova27, G.M. Savelyeva28, Yu.A. Semenov29, S.I. Sitkin30, I.F. Fatkullin31, T.A. Fedorova5, O.S. Filippov32, M.V. Shvechkova33, R.G. Shmakov5, A.V. Shchegolev34, I.B. Zabolotskikh6

1 FUV SBHCI MR “MONIKI named M.F. Vladimirsky”, Moscow, Russia

2 Ural State Medical University, Ministry of Health of Russia, Yekaterinburg, Russia

3 SBHCI Tver region “Regional Clinical Perinatal Center named EM. Bakunina”, Tver, Russia

4 SBHCI “Republican Clinical Hospital” of the Ministry of Health of the Kabardino-Balkarian Republic, Nalchik, Russia

5 FSBI “NMTC OGP named academic V.I. Kulakov” Ministry of Health of Russia, Moscow, Russia

6 FSBEI of HE “Kuban State Medical University” of the Ministry of Health of Russia, Krasnodar, Russia

7 Kemerovo State Medical University, Ministry of Health of Russia, Kemerovo, Russia

8 FSBEI of HE “Omsk State Medical University” of the Ministry of Health of Russia, Omsk, Russia

9 FSBEI of HE “Chita State Medical Academy” of the Ministry of Health of Russia, Chita, Russia

10 Clinical Maternity Hospital No. 6, Omsk, Russia

11 SBHCI “GKB behalf of S.P. Botkin” Moscow Department of Health, Moscow, Russia

12 SBHCI Volgograd Regional Clinical Perinatal Center No. 1 named L.I. Ushakova, Volgograd, Russia

13 SBHCI SO “Togliatti City Clinical Hospital № 5”, Tolyatti, Russia

14 RSAHCI “Irkutsk city perinatal center”, Irkutsk, Russia

15 FSBEI of HE “Far Eastern State Medical University” of the Ministry of Health of Russia, Khabarovsk, Russia

16 FSBEI of HE “Novosibirsk National Research State University” (NSU), Novosibirsk, Russia

17 Ural Research Institute for the Protection of Motherhood and Infancy, Ministry of Health of Russia, Yekaterinburg, Russia

18 SBHCI of HE “Astrakhan State Medical University” of the Ministry of Health of the Russian Federation, Astrakhan, Russia

19 Federal State Scientific Institution “Research Institute of Obstetrics, Gynecology and Reproductology named D.O. Ott”, St. Petersburg, Russia

20 SBHCI MR “Moscow Regional Research Institute of Obstetrics and Gynecology”, Moscow, Russia

21 Tyumen State Medical University, Tyumen, Russia

22 “RNRU named N.I. Pirogov” Ministry of Health of Russia, Moscow, Russia

23 FSBEI HE “Saratov State Medical University named VI. Razumovsky”, Saratov, Russia

24 SBHCI SR CSTO № 1, OPC, Yekaterinburg, Russia

25 Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia

26 KSBHCI Krasnoyarsk Regional Clinical Center for the Protection of Motherhood and Childhood, Krasnoyarsk, Russia

27 SBRI VPO “St. Petersburg State Pediatric Medical University”, St. Petersburg, Russia

28 FFM Moscow State University named M.V. Lomonosov», Moscow, Russia

29 SBHCI “Regional Perinatal Center”, Chelyabinsk, Russia

30 Tver State Medical University, Ministry of Health of Russia, Tver, Russia

31 Kazan State Medical University, Ministry of Health of Russia, Kazan, Russia

32 FSBEI of HE “Moscow State University of Medicine and Dentistry named A.I. Evdokimov”, Moscow, Russia

33 SBHCI TR “Perinatal Center”, Tyumen, Russia

34 FSMEI HVE “Military Medical Academy named S.M. Kirov”, St. Petersburg, Russia

For correspondence: Alexander M. Ronenson — Head of the Department of Anesthesiology and Intensive care of SBHCI Tver region “Regional Clinical Perinatal Center named E.M. Bakunina”, Tver; e-mail: a.ronenson@mail.ru

For citation: Shifman EM, Kulikov AV, Ronenson AM, Abazova IS, Adamyan LV, Andreeva MD, Artymuk NV, Baev OR, Barinov SV, Belokrinitskaya TE, Blauman SI, Bratishchev IV, Bukhtin AA, Vartanov VY, Volkov AB, Gorokhovskiy VS, Dolgushina NV, Drobinskaya AN, Kinzhalova SV, Kitiashvili IZ, Kogan IYu, Korolev AYu, Krasnopolskii VI, Kukarskaya II, Kurcer MA, Marshalov DV, Matkovskiy AA, Ovezov AM, Penzhoyan GA, Pestrikova TYu, Petruhin VA, Prihodko AM, Protopopova NV, Protsenko DN, Pyregov AV, Raspopin YuS, Rogachevskiy OV, Ryazanova OV, Savelyeva GM, Semenov YuA, Sitkin SI, Fatkullin IF, Fedorova TA, Filippov OS, Shvechkova MV, Shmakov RG, Shchegolev AV, Zabolotskikh IB. Prevention, the algorithm of reference, anesthesia and intensive care for postpartum hemorrhage. Guidelines. Annals of Critical Care. 2019;3:9–33.

DOI: 10.21320/1818-474X-2019-3-9-33


Abstract

The article observes the main provisions of the clinical recommendations for prevention, anesthesia and intensive care for postpartum hemorrhage. The main risk factors, possible complications, principles of clinical and laboratory diagnosis in this pathology are consistently presented. Particular attention is paid to issues of infusion, transfusion therapy and correction of coagulopathic disorders. The problems of estimating the amount of blood loss, diagnosing disorders of the hemostatic system, regulation of hemodynamics in hemorrhagic shock are discussed. The use of recombinant coagulation factors in coagulopathy on the background of massive blood loss has been substantiated.

Keywords: obstetrics, uterine atony, hemorrhagic shock, hemostatic therapy, DIC, infusion-transfusion therapy, coagulopathy, coagulation disorders, postpartum hemorrhage, vaginal laceration, uterotonic agents.

Received: 07.07.2019

Accepted: 03.09.2019


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