Prise en charge d'une hémorragie du post-partum

Post-partum haemorrhage is the leading cause of maternal death in France and in the world, defined as a blood loss of 500 ml or more in the 24 hours following delivery. Recent French guidelines have been published in order to reduce maternal morbidity and mortality. Multidisciplinary management includes manual removal of the placenta and control of the uterine cavity and the vaginal wall, uterotonic drugs such as ocytocin and prostaglandins and blood volume expansion, red blood cell transfusion and clotting disorders treatment. In life-threatening post-partum haemorrhage, arterial ligature or embolization may be used and hysterectomy is the ultimate available option. Optimal care system includes obstetrician and anesthetist presence in the labour ward, laboratory and blood products access and preemptive convention with a conditioned critical care unit.