Strategies to manage postpartum haemorrhage

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Parry-Smith, William Rhys ORCID: https://orcid.org/0000-0002-0017-7266 (2020). Strategies to manage postpartum haemorrhage. University of Birmingham. M.D.

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Abstract

Postpartum haemorrhage (PPH) is a global problem and the solutions to reducing it are complex. This thesis uses a mixture of research methods to investigate strategies that might improve the burden of blood loss following childbirth.

The main findings are:

1. The use of contraception medication prior to pregnancy warrants further research as progesterone only contraception in particular might be associated with an increase in the risk of subsequent PPH;

2. The use of antidepressant medication during late pregnancy does not appear to increase the risk of PPH;

3. Following childbirth, a preventative uterotonic drug may not need to be given immediately; a delay of up to 5 minutes does not appear to increase the risk of bleeding;

4. There is little evidence to recommend the use of oxytocin, carbetocin, or misoprostol over each other for use as a first line drug to treat PPH;

5. Less than half of patients who had a PPH of 500mL received treatment uterotonic medication;

6. There is no appreciable long-term effect of PPH on mental health, but there is an increased risk of developing postnatal depression and post traumatic stress disorder;

7. There is no appreciable effect of PPH on cardiovascular health.

Type of Work:

Thesis (Doctorates > M.D.)

Award Type:

Doctorates > M.D.

Supervisor(s):