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Postpartum hemorrhage care bundles to improve adherence to guidelines: A WHO technical consultation

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ID Minciencias: ART-0001363624-45
Ranking: ART-ART_A1

Abstract:

Abstract Objective To systematically develop evidence‐based bundles for care of postpartum hemorrhage ( PPH ). Methods An international technical consultation was conducted in 2017 to develop draft bundles of clinical interventions for PPH taken from the WHO 's 2012 and 2017 PPH recommendations and based on the validated “ GRADE Evidence‐to‐Decision” framework. Twenty‐three global maternal‐health experts participated in the development process, which was informed by a systematic literature search on bundle definitions, designs, and implementation experiences. Over a 6‐month period, the expert panel met online and via teleconferences, culminating in a 2‐day in‐person meeting. Results The consultation led to the definition of two care bundles for facility implementation. The “first response to PPH bundle” comprises uterotonics, isotonic crystalloids, tranexamic acid, and uterine massage. The “response to refractory PPH bundle” comprises compressive measures (aortic or bimanual uterine compression), the non‐pneumatic antishock garment, and intrauterine balloon tamponade ( IBT ). Advocacy, training, teamwork, communication, and use of best clinical practices were defined as PPH bundle supporting elements. Conclusion For the first response bundle, further research should assess its feasibility, acceptability, and effectiveness; and identify optimal implementation strategies. For the response to refractory bundle, further research should address pending controversies, including the operational definition of refractory PPH and effectiveness of IBT devices.

Tópico:

Maternal and fetal healthcare

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Citations: 83
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Información de la Fuente:

SCImago Journal & Country Rank
FuenteInternational Journal of Gynecology & Obstetrics
Cuartil año de publicaciónNo disponible
Volumen148
Issue3
Páginas290 - 299
pISSNNo disponible
ISSN1879-3479

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