Suellen Miller, RN, CNM, MHA, PhD, is Director of Safe Motherhood Programs, the Women's Global Health Imperative, University of California, San Francisco, Department of Obstetrics, Gynecology, and Reproductive Sciences, and Adjunct Assistant Professor, University of California, Berkeley, School of Public Health, Maternal and Child Health Program. Dr. Miller is researching postpartum hemorrhage prevention and treatment in Egypt, Nigeria, Mexico, and Tibet.
CEU: Prevention and Treatment of Postpartum Hemorrhage: New Advances for Low-Resource Settings
Article first published online: 24 DEC 2010
2004 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 49, Issue 4, pages 283–292, July-August 2004
How to Cite
Miller, S., Lester, F. and Hensleigh, P. (2004), CEU: Prevention and Treatment of Postpartum Hemorrhage: New Advances for Low-Resource Settings. Journal of Midwifery & Womens Health, 49: 283–292. doi: 10.1016/j.jmwh.2004.04.001
- Issue published online: 24 DEC 2010
- Article first published online: 24 DEC 2010
- postpartum hemorrhage;
Postpartum hemorrhage due to uterine atony is the primary direct cause of maternal mortality globally. Management strategies in developed countries involve crystalloid fluid replacement, blood transfusions, and surgery. These definitive therapies are often not accessible in developing countries. Long transports from home or primary health care facilities, a dearth of skilled providers, and lack of intravenous fluids and/or a safe blood supply often create long delays in instituting appropriate treatment. We review the evidence for active management of third-stage labor and for the use of specific uterotonics. New strategies to prevent and manage postpartum hemorrhage in developing countries, such as community-based use of misoprostol, oxytocin in the Uniject delivery system, the non-inflatable antishock garment to stabilize and resuscitate hypovolemic shock, and the balloon condom catheter to treat intractable uterine bleeding are reviewed. New directions for clinical and operations research are suggested.