Update on Obstetric Hemorrhage

Postpartum hemorrhage is increasing in prevalence in the USA and continues to be an important cause of preventable maternal morbidity and mortality. This review provides the most recent epidemiologic data on postpartum hemorrhage in the USA, current nationwide initiatives for prevention, preparedness, and response to postpartum hemorrhage, and recent evidence-based advances in management. The National Partnership for Maternal Safety consensus bundle on obstetric hemorrhage serves as a resource for postpartum hemorrhage–related clinical and research initiatives. Areas of focus include standardizing postpartum hemorrhage management with protocol use, massive transfusion protocols, early and enhanced risk assessment, accurate quantitation of blood loss, and refined transfusion strategies such as early fibrinogen replacement, tranexamic acid therapy, and point of care testing to detect and treat coagulopathy. Continued focus on improving the management of postpartum hemorrhage with available resources is imperative to minimize associated risks of morbidity and mortality.