DOI: 10.36347/sjams.2016.v04i10.015

Pages: 3612-3623

Obstetric haemorrhage is the one of the most common cause of maternal mortality worldwide accounting for 25-30%of all maternal deaths. Most of these deaths occur during labour, delivery or in the immediate postpartum period. The management of postpartum haemorrhage poses a threat to the developing as well as developed nations. Even today, in India most of the deliveries are unsupervised in the rural setting. One of the biggest shortcomings to the Millennium Development Goal 2015 of reducing the maternal mortality to 109/100,000 is dearth of specialists including anaesthesiologists at the level of primary care .Postpartum haemorrhage(PPH) is a life threatening situation. Simultaneous teamwork involving the obstetrician, anaesthesiologist ,haematologist, radiologist, operation theatre and labour room ,blood bank department is crucial for preventing mortality .Multiple tasks are to be performed by anaesthesiologists including resuscitation, monitoring vital signs, estimating blood loss, ordering and procuring blood and blood components ,activation of massive transfusion protocol, anaesthesia for various procedures to control bleeding including interventional radiology. The objective of this review is to familiarize the anaesthesiologist with the latest trends in transfusion practice and monitoring such as early use of fibrinogen concentrate based on point of care testing along with FIBTEM A5 has revolutionised the management of post-partum haemorrhage which is a must know for every anaesthesiologist. Finally a local protocol to be applicable in a tertiary care centre is outlined so that prompt measures can be taken so that mother’s lives are not in jeopardy.