Abstract
Author(s): JAN OLESZCZUK, BOÅ»ENA LESZCZYÅSKA-GORZELAK, DARIUSZ SZYMULA,BEATA MARCINIAK, MAGDALENA MICHALAK, ANNA MICHAÅOWSKA
Primary postpartum haemorrhage (PPH) occurs in 3.9% - 5% of all deliveries and often developsinto secondary postpartum haemorrhage with an occurrence rate estimated to be ca. 1%. In0.05% of cases it ends in hysterectomy and is the main cause of death among the five majorfactors of maternal mortality, in both developing and developed countries. Postpartum haemor-rhage is - beside eclampsia - the most frequent cause of admission to medical intensive careunits. In Europe, the reported rate of massive postpartum haemorrhage differs significantlybetween individual countries. It is estimated that in the developing countries ca. 140,000 ofwomen die due to postpartum haemorrhage every year In the management of postpartum haemorrhage, it is crucial to identify the risk factors andto undertake preventive measures. It must be remembered, though, that sometimes massivehaemorrhage may occur without any premonitory risk factors, and that increased bleeding wasreported in groups of both high and low haemorrhage risk.In case of postpartum haemorrhage it is important to implement immediately correct pharma-cological, manual, and surgical procedures. Avoiding delays in the life-saving treatment in-reases significantly the patient’s chances of survival. Postpartum haemorrhage itself is notdangerous - what is dangerous is tardiness in managing it, hence the essential importance ofadequate training of the medical staff with respect to correct PPH management. Proper caredevoted to treating a patient with haemorrhage is decisive for her survival. Competence andprompt action are crucial in arresting life-threatening bleeding. Correct organization of PPHpatient care may totally exclude maternal mortality due to massive postpartum haemorrhage,an evidence of which is PPH SWAT in Lublin (Lublin System of Special Weapons and Tacticsin postpartum hemorrhage).