Diagnosis and treatment of peripartum haemorrhage, consensus of the interdisciplinary working group by the modified ACCORD method

1. Pařízek A, Binder T, Bláha J et al. Diagnostika a léčba peripartálního život ohrožujícího krvácení. Ceska Gynekol 2018; 83 (2): 150–157.

2. Gattrell WT, Logullo P, van Zuuren EJ et al. ACCORD (ACcurate COnsensus Reporting Document): a reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLoS Med 2024; 21 (1): e1004326. doi: 10.1371/journal.pmed.1004326.

3. Guideline Development Tool. 2024 [online]. Available from: https: //gdt.gradepro.org/app/#organizations.

4. Kramer MS, Berg C, Abenhaim H et al. Incidence, risk factors, and temporal trends in severe postpartum hemorrhage. Am J Obstet Gynecol 2013; 209 (5): 449.e1–449.e7. doi: 10.1016/j.ajog.2013.07.007.

5. Patek K, Friedman P. Postpartum hemorrhage-epidemiology, risk factors, and causes. Clin Obstet Gynecol 2023; 66 (2): 344–356. doi: 10.1097/GRF.00000000000000782.

6. Rath WH. Postpartum hemorrhage – update on problems of definitions and diagnosis. Acta Obstet Gynecol Scand 2011; 90 (5): 421–428. doi: 10.1111/j.1600-0412.2011.01107.x.

7. Ginnane JF, Aziz S, Sultana S et al. The cost-effectiveness of preventing, diagnosing, and treating postpartum haemorrhage: a systematic review of economic evaluations. PLoS Med 2024; 21 (9): e1004461. doi: 10.1371/journal.pmed.1004461.

8. Glonnegger H, Glenzer MM, Lancaster L et al. Prepartum anemia and risk of postpartum hemorrhage: a meta-analysis and brief review. Clin Appl Thromb Hemost 2023; 29: 10760296231214536. doi: 10.1177/107602962 31214536.

9. Radhika AG, Sharma AK, Perumal V et al. Parenteral versus oral iron for treatment of iron deficiency anaemia during pregnancy and post-partum: a systematic review. J Obstet Gynaecol India 2019; 69 (1): 13–24. doi: 10.1007/s13224- 018-1191-8.

10. Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants. 2024 [online]. Available from: https: //www.who.int/tools/elena/interventions/cord-clamping.

11. Seidler AL, Libesman S, Hunter KE et al. Short, medium, and long deferral of umbilical cord clamping compared with umbilical cord milking and immediate clamping at preterm birth: a systematic review and network meta-analysis with individual participant data. Lancet 2023; 402 (10418): 2223–2234. doi: 10.1016/ S0140-6736 (23) 02469-8.

12. Parry Smith WR, Papadopoulou A, Thomas E et al. Uterotonic agents for first-line treatment of postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev 2020; 11 (11): CD012754. doi: 10.1002/14651858.CD012757.pub2.

13. Onwochei DN, Owolabi A, Singh PM et al. Carbetocin compared with oxytocin in non-elective Cesarean delivery: a systematic review, meta-analysis, and trial sequential analysis of randomized-controlled trials. Can J Anaesth 2020; 67 (11): 1524–1534. doi: 10.1007/s126 30-020-01779-1.

14. Oladapo OT, Okusanya BO, Abalos E et al. Intravenous versus intramuscular prophylactic oxytocin for reducing blood loss in the third stage of labour. Cochrane Database Syst Rev 2020; 11 (11): CD009332. doi: 10.1002/14651858.CD009332.pub4.

15. Ginnane JF, Aziz S, Sultana S et al. The cost-effectiveness of preventing, diagnosing, and treating postpartum haemorrhage: a systematic review of economic evaluations. PLoS Med 2024; 21 (9): e1004461. doi: 10.1371/journal.pmed.1004461.

16. Torloni MR, Siaulys M, Riera R et al. Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: a systematic review and metanalysis. PLoS One 2021; 16 (6): e0252491. doi: 10.1371/journal.pone.0252491.

17. Kalafat E, Gokce A, O’Brien P et al. Efficacy of carbetocin in the prevention of postpartum hemorrhage: a systematic review and Bayesian meta-analysis of randomized trials. J Matern Neonatal Med 2021; 34 (14): 2303–2316. doi: 10.1080/14767058.2019.1664463.

18. Ai W, Zeng Y, Ma Y et al. Side-effects of carbetocin to prevent postpartum hemorrhage: a systematic review and meta-analysis of randomized controlled trials. Pharmacol Res Perspect 2021; 9 (2): e00745. doi: 10.1002/prp2.745.

19. Jaffer D, Singh PM, Aslam A et al. Preventing postpartum hemorrhage after cesarean delivery: a network meta-analysis of available pharmacologic agents. Am J Obstet Gynecol 2022; 226 (3): 347–365. doi: 10.1016/ j.ajog.2021.08.060.

20. Kadirogullari P, Aslan Cetin B, Goksu M et al. The effect of uterine massage after vaginal delivery on the duration of placental delivery and amount of postpartum hemorrhage. Arch Gynecol Obstet 2024; 309 (6): 2689–2695. doi: 10.1007/s00404-023-07211-5.

21. Hofmeyr GJ, Abdel-Aleem H, Abdel-Aleem MA. Uterine massage for preventing postpartum haemorrhage. Cochrane Database Syst Rev 2013; 2013 (7): CD006431. doi: 10.1002/14651858.CD006431.pub3.

22. Heesen M, Orbach-Zinger S. Optimal uterotonic management. Best Pract Res Clin Anaesthesiol 2022; 36 (1): 135–155. doi: 10.1016/ j.bpa.2022.02.002.

23. Chao YS, McCormack S. Carbetocin for the prevention of post-partum hemorrhage: a review of clinical effectiveness, cost-effectiveness, and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Helth 2019.

24. Shakur H, Roberts I, Fawole B et al. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet 2017; 389 (10084): 2105–2116. doi: 10.1016/S0140-67 36 (17) 30638-4.

25. Figo. Joint statement of recommendation for the use of tranexamic acid for the treatment of postpartum haemorrhage. 2024 [online]. Available from: https: //www.figo.org/joint-statement-recommendation-tranexamic-acid-treatment-pph.

26. Chipman ML, Schreiber CM, Fey JM et al. Engagement across professions: a mixed methods study of debriefing after interprofessional team training. Simul Healthc 2024; 19 (4): 228–234. doi: 10.1097/SIH.00000000000 00736.

27. Cheng A, Grant V, Eppich W. The PEARLS debriefing checklist – optimal use for faculty development. Simul Healthc 2024; 19 (4): 265–266. doi: 10.1097/SIH.0000000000000816.

28. Fanning RM, Gaba DM. The role of debriefing in simulation-based learning. Simul Healthc 2007; 2 (2): 115–125. doi: 10.1097/SIH.0b013e 3180315539.

29. D’Alton ME, Rood KM, Smid MC et al. Intrauterine vacuum-induced hemorrhage-control device for rapid treatment of postpartum hemorrhage. Obstet Gynecol 2020; 136 (5): 882–891. doi: 10.1097/AOG.00000000000 04138.

30. The JADA System. Postpartum hemorrhage Control. 2024 [online]. Available from: https: //www.thejadasystem.com/.

31. Storms J, Van Calsteren K, Lewi L et al. Interventional radiology for prevention and management of postpartum haemorrhage: a single centre retrospective cohort study. Arch Gynecol Obstet 2024. doi: 10.1007/s00404-024-07 595-y.

32. Kurup M, Bidarahalli S, Sadananda A et al. Role of interventional radiology in obstetrics and gynaecology: a clinical review of an experience in a quaternary care centre. Arch Gynecol Obstet 2024; 309 (2): 581–588. doi: 10.1007/s00404-023-07273-5.

33. Gorsi U, Bansal A, Chaluvashetty SB et al. Interventional radiology in the management of uncommon causes of obstetric haemorrhage. Eur J Radiol 2021; 134: 109415. doi: 10.1016/ j.ejrad.2020.109415.

34. Kellie FJ, Wandabwa JN, Mousa HA et al. Mechanical and surgical interventions for treating primary postpartum haemorrhage. Cochrane database Syst Rev 2020; 7 (7): CD013663. doi: 10.1002/14651858.CD013663.

35. Rossaint R, Afshari A, Bouillon B et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care 2023; 27 (1): 80. doi: 10.1186/s13054-023-04327-7.

36. Schol PB, de Lange N, Henskens Y et al. Restrictive versus liberal fluid administration strategy (REFILL study) in postpartum hemorrhage and its effects on thromboelastometry (ROTEM®) values: a randomized, controlled trial. J Int Med Res 2023; 51 (8): 3000605231171007. doi: 10.1177/03000605231171007.

37. Henriquez DD, Bloemenkamp KW, Loeff RM et al. Fluid resuscitation during persistent postpartum haemorrhage and maternal outcome: a nationwide cohort study. Eur J Obstet Gynecol Reprod Biol 2019; 235: 49–56. doi: 10.1016/ j.ejogrb.2019.01.027.

38. Ramesh GH, Uma JC, Farhath S. Fluid resuscitation in trauma: what are the best strategies and fluids? Int J Emerg Med 2019; 12 (1): 38. doi: 10.1186/s12245-019-0253-8.

39. Gruneberg D, Hofer S, Schöchl H et al. Comparison of two biscoelastic testing devices in a parturient population. J Clin Med 2024; 13 (3): 692. doi: 10.3390/jcm13030692.

40. Bell SF, de Lloyd L, Preston N et al. Managing the coagulopathy of postpartum hemorrhage: an evolving role for viscoelastic hemostatic assays. J Thromb Haemost 2023; 21 (8): 2064–2077. doi: 10.1016/j.jtha.2023.03.029.

41. Graves SM, Montemorano L, Rood KM et al. Viscoelastic testing in an obstetric population at high risk of hemorrhage. Am J Perinatol 2024; 41 (7): 915–923. doi: 10.1055/a-1788- 5025.

42. Perelman AD, Limaye M, Blakemore J et al. Thromboelastography versus standard coagulation assays in patients with postpartum hemorrhage. Am J Perinatol 2024; 41 (S 01): e911–e916. doi: 10.1055/a-1974-5055.

43. De Robertis E, Kozek-Langenecker SA, Tufano R et al. Coagulopathy induced by acidosis, hypothermia and hypocalcaemia in severe bleeding. Minerva Anestesiol 2015; 81 (1): 65–75.

44. Ditzel RM, Anderson JL, Eisenhart WJ et al. A review of transfusion – and trauma-induced hypocalcemia: is it time to change the lethal triad to the lethal diamond? J Trauma Acute Care Surg 2020; 88 (3): 434–439. doi: 10.1097/TA.0000000000002570.

45. Schriner JB, Van Gent JM, Meledeo MA et al. Impact of transfused citrate on pathophysiology in massive transfusion. Crit Care Explor 2023; 5 (6): e0925. doi: 10.1097/CCE.000000000000925.

46. Erfani H, Shamshirsaz AA, Fox KA et al. Severe hypocalcemia during surgery for placenta accreta spectrum: the case for empiric replacement. Acta Obstet Gynecol Scand 2019; 98 (10): 1326–1331. doi: 10.1111/aogs.13636.

47. Epstein D, Solomon N, Korytny A et al. Association between ionised calcium and severity of postpartum haemorrhage: a retrospective cohort study. Br J Anaesth 2021; 126 (5): 1022–1028. doi: 10.1016/j.bja.2020.11.020.

48. Hofer S, Blaha J, Collins PW et al. Haemostatic support in postpartum haemorrhage: a review of the literature and expert opinion. Eur J Anaesthesiol 2023; 40 (1): 29–38. doi: 10.1097/EJA.0000000000001744.

49. Ducloy-Bouthors AS, Mercier FJ, Grouin JM et al. Early and systematic administration of fibrinogen concentrate in postpartum haemorrhage following vaginal delivery: the FIDEL randomised controlled trial. BJOG 2021; 128 (11): 1814–1823. doi: 10.1111/1471-0528. 16699.

50. Lier H, Annecke T, Girard T et al. Peripartum haemorrhage: haemostatic aspects of the updated peripartum haemorrhage guideline of the German-speaking countries. Transfus Med Hemother 2023; 50 (6): 547–558. doi: 10.1159/000530659.

51. de Lloyd L, Jenkins PV, Bell SF et al. Acute obstetric coagulopathy during postpartum hemorrhage is caused by hyperfibrinolysis and dysfibrinogenemia: an observational cohort study. J Thromb Haemost 2023; 21 (4): 862–879. doi: 10.1016/j.jtha.2022.11.036.

52. Bouthors AS. Crucial new insights into the understanding and treatment of acute obstetric coagulopathy. J Thromb Haemost 2023; 21 (4): 779. doi: 10.1016/j.jtha.2022.12.010.

53. Bell SF, de Lloyd L, Preston N et al. Managing the coagulopathy of postpartum hemorrhage: an evolving role for viscoelastic hemostatic assays. J Thromb Haemost 2023; 21 (8): 2064–2077. doi: 10.1016/j.jtha.2023.03.029.

54. Collins P, Abdul-Kadir R, Thachil J. Management of coagulopathy associated with postpartum hemorrhage: guidance from the SSC of the ISTH. J Thromb Haemost 2016; 14 (1): 205–210. doi: 10.1111/jth.13174.

55. Surbek D, Blatný J, Wielgos M et al. Role of recombinant factor VIIa in the clinical management of severe postpartum hemorrhage: consensus among European experts. J Matern Fetal Neonatal Med 2024; 37 (1): 2332794. doi: 10.1080/14767058.2024.2332794.

56. Cines DB, Levine LD. Thrombocytopenia in pregnancy. Hematol Am Soc Hematol Educ Program 2017; 2017 (1): 144–151. doi: 10.1182/asheducation-2017.1.144.

57. Practice Bulletin No. 166: Thrombocytopenia in pregnancy. Obstet Gynecol 2016; 128 (3): e43–e53. doi: 10.1097/AOG.00000000000 01641.

58. Estcourt LJ, Malouf R, Doree C et al. Prophylactic platelet transfusions prior to surgery for people with a low platelet count. Cochrane database Syst Rev 2018; 9 (9): CD012779. doi: 10.1002/14651858.CD012779.pub2.

59. Wang L, Zhong J, Xiao D et al. Thrombomodulin (TM), thrombin-antithrombin complex (TAT), plasmin-a2-plasmininhibitor complex (PIC), and tissue plasminogen activator-inhibitor complex (t-PAIC) assessment of fibrinolytic activity in postpartum hemorrhage: a retrospective comparative cohort study. Ann Transl Med 2022; 10 (23): 1273. doi: 10.21037/atm-22-5221.

60. Middeldorp S, Naue C, Köhler C. Thrombophilia, thrombosis and thromboprophylaxis in pregnancy: for what and in whom? Hamostaseologie 2022; 42 (1): 54–64. doi: 10.1055/a-1717- 7663.

61. Erez O, Othman M, Rabinovich A et al. DIC in pregnancy – pathophysiology, clinical characteristics, diagnostic scores, and treatments. J Blood Med J Blood Med 2022; 13: 21–44. doi: 10.2147/JBM.S273047.

62. Squizzato A, Gallo A, Levi M et al. Underlying disorders of disseminated intravascular coagulation: communication from the ISTH SSC subcommittees on disseminated intravascular coagulation and perioperative and critical care thrombosis and hemostasis. J Thromb Haemost 2020; 18 (9): 2400–2407. doi: 10.1111/jth. 14946.

63. Iba T, Saitoh D, Wada H et al. Efficacy and bleeding risk of antithrombin supplementation in septic disseminated intravascular coagulation: a secondary survey. Crit Care 2014; 18 (5): 497. doi: 10.1186/s13054-014-0497-x.

64. Yatabe T, Inoue S, Sakamoto S et al. The anticoagulant treatment for sepsis induced disseminated intravascular coagulation; network meta-analysis. Thromb Res 2018; 171: 136–142. doi: 10.1016/j.thromres.2018.10.007.

65. Allingstrup M, Wetterslev J, Ravn FB et al. Antithrombin III for critically ill patients. Cochrane Database Syst Rev 2016; 2 (2): CD005370. doi: 10.1002/14651858.CD005370.pub3.

66. Rodgers GM, Mahajerin A. Antithrombin therapy: current state and future outlook. Clin Appl Thromb Hemost 2023; 29. 10760296231205279. doi: 10.1177/10760296231205279.

67. Tagami T. Antithrombin concentrate use in sepsis-associated disseminated intravascular coagulation: re-evaluation of a ‘pendulum effect’ drug using a nationwide database. J Thromb Haemost 2018; 16 (3): 458–461. doi: 10.1111/jth.13948.

68. Allingstrup M, Wetterslev J, Ravn FB et al. Antithrombin III for critically ill patients: a systematic review with meta-analysis and trial sequential analysis. Intensive Care Med Intensive Care Med 2016; 42 (4): 505–520. doi: 10.1007/s00134-016-4225-7.

69. Ryu T, Kurokawa Y, Hirayu N et al. Resuscitative endovascular balloon occlusion of the aorta: a novel approach for treating amniotic fluid embolism with disseminated intravascular coagulopathy – a report of two cases. J Obstet Gynaecol Res 2024; 50 (9): 1722–1727. doi: 10.1111/jog.16007.

70. Metodika CRediT (Contributor Roles Taxonomy). 2024 [online]. Available from: https: //www.elsevier.com/researcher/author/policies-and-guidelines/credit-author-statement.

Doručeno/Submitted: 18. 11. 2024

Přijato/Accepted: 18. 11. 2024

prof. MUDr. Antonín Pařízek, CSc.

Perinatologické centrum

Klinika gynekologie, porodnictví a neonatologie

1. LF UK a VFN v Praze

Apolinářská 18

128 51 Praha 2

parizek@porodnice.cz

Seznam zkratek

ACCORD – ACcurate COnsensus Reporting Document

aPTT – aktivovaný parciální tromboplastinový čas

AT III – antitrombin III

ČGPS – Česká gynekologická a porodnická společnost ČLS JEP

ČHS – Česká hematologická společnost ČLS JEP

ČLS JEP – Česká lékařská společnost Jana Evangelisty Purkyně

ČSARIM – Česká společnost anesteziologie, resuscitace a intenzivní medicíny ČLS JEP

ČSTH – Česká společnost pro trombózu a hemostázu

EMA – Evropská agentura pro léčivé přípravky

ERI – endovaskulární radiologická intervence

KO – krevní obraz

NIKEZ – Národní institut kvality a excelence zdravotnictví

OS – odborná společnost

PAS – placenta accreta spectrum

PCC – koncentrát protrombinového komplexu

PPH – postpartum haemorrhage; postpartální hemoragie

PT – protrombinový čas

PŽOK – peripartální život ohrožující krvácení

PS – pracovní skupina

rFVIIa – rekombinantní aktivovaný faktor VII

REBOA – resuscitative endovascular balloon occlusion of the aorta

ROTEM – rotační tromboelastometrie

SK – syntetický koloid

SPC – Summaries of Product Characteristics

STK – systolický krevní tlak

TEG – tromboelastografie

TXA – kyselina tranexamová