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Anesthesia for the patient with peripartum hemorrhage

Jill M Mhyre, MD
Faiza A Khan, MD
Section Editor
David L Hepner, MD
Deputy Editor
Marianna Crowley, MD


Peripartum hemorrhage is a major cause of maternal morbidity and mortality. Effective management requires a multidisciplinary, structured approach, with recognition that obstetric hemorrhage can rapidly become life threatening. This topic will discuss the anesthetic management of patients with peripartum hemorrhage or conditions that increase the risk of such hemorrhage.

Obstetric management of these patients and the approach to the management of postpartum hemorrhage (PPH) are discussed in detail separately. (See "Overview of postpartum hemorrhage" and "Postpartum hemorrhage: Medical and minimally invasive management" and "Postpartum hemorrhage: Management approaches requiring laparotomy" and "Placental abruption: Management" and "Placenta previa: Management" and "Velamentous umbilical cord insertion and vasa previa" and "Uterine rupture after previous cesarean delivery" and "Peripartum hysterectomy for management of hemorrhage".)


Antenatal anesthesia consultation should be arranged for patients at high risk of peripartum hemorrhage and those for whom blood product preparation or transfusion may be complicated. (See "Overview of postpartum hemorrhage", section on 'Management of risk'.)

All obstetric patients should be evaluated for potential difficulty with airway management to create a plan for safe airway management in case general anesthesia is necessary. (See "Airway management of the pregnant patient at delivery", section on 'Identify patients with a difficult airway'.)

In addition to the usual medical and prenatal history, and anesthesia-directed physical examination, the following considerations should be addressed antenatally whenever time permits.

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Literature review current through: Nov 2017. | This topic last updated: May 30, 2017.
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