Transition of Guidelines for Treating Obstetric Critical Hemorrhage：2010 to 2017 Version

Abstract

Obstetric critical hemorrhage remains the leading cause of maternal death. Three major causes of obstetric critical hemorrhage are amniotic fluid embolism, uterine atony, and uterine rupture. It is important to secure surgical hemostasis and start blood transfusion early with a 1：1 ratio of red cell concentrate to fresh frozen plasma. Because fibrinogen is the key factor for hemostasis, fibrinogen levels should be maintained by fresh frozen plasma, cryoprecipitate, or fibrinogen concentrate if necessary. The new guidelines for treating obstetric critical hemorrhage published in 2017 are expected to improve maternal outcome.