Episode 159: Postpartum hemorrhage with Juanita Henao

In this 159th episode I welcome Dr. Juanita Henao to the show to discuss prevention and management of postpartum hemorrhage.

One CORRECTION: At about minute 4:30 Dr. Henao states that in women with PPH the mortality rate is 10% but what she meant to say is that PPH accounts for 10% of maternal deaths in the United States.

References:

Thorneloe, J.C.A. Carvalho, K. Downey,M. Balki. Uterotonic drug usage in Canada: a snapshot of the practice in obstetric units of university-affiliated hospitals. Int J Obstet Anesth. 2019 Feb;37:45-51.

Hian Yan Voon , Haris Njoo Suharjono , Asrul Akmal Shafie , Mohamad Adam Bujang Carbetocin versus oxytocin for the prevention of postpartum hemorrhage: A meta-analysis of randomized controlled trials in cesarean deliveries. Taiwan J Obstet Gynecol. 2018 Jun;57(3):332-339.

WOMAN trial collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet. 2017 May 27;389(10084):2105-2116.

Main EKGoffman DScavone BMLow LKBingham DFontaine PLGorlin JBLagrew DCLevy BSNational Partnership for Maternal SafetyCouncil on Patient Safety in Women’s Health Care.National Partnership for Maternal Safety: Consensus Bundle on Obstetric Hemorrhage. Obstet Gynecol. 2015 Jul;126(1):155-62.

Duffield A1McKenzie CCarvalho BRamachandran BYin VEl-Sayed YYRiley ETButwick AJ. Effect of a High-Rate Versus a Low-Rate Oxytocin Infusion for Maintaining Uterine Contractility During Elective Cesarean Delivery: A Prospective Randomized Clinical Trial. Anesth Analg. 2017 Mar;124(3):857-862

David H. Chestnut, Cynthia A Wong, Lawrence C Tsen, Warwick D Ngan Kee, Yaakov Beilin, Jill Mhyre. Chestnut’s Obstetric Anesthesia: Principles and Practice. Fifth edition. Chapter 38, Anterpartum and Postpartum, Hemorrhage. 

5 Replies to “Episode 159: Postpartum hemorrhage with Juanita Henao”

  1. Great guest, excellent clarity and really appreciate the speed at which you both speak, makes it much easier to absorb.

    Love the podcast.

    I’m in Anaesthesia training in Australia, my one request would be where possible, is there any chance you could use generic drug names in place of trade names? It would mean the world to me not to have to look up “American names” for drugs 😂

    1. Thanks Asha, international listeners have pointed this out over the years and you’re absolutely right, we’ll keep trying to do a better job with this!

  2. Good morning, excellent podcast, thank you so much. All of your podcasts have been extremely valuable and are used as a lecture series within my residency..
    We have started prophylactically deploying reoba in patients at high risk for PPH with morbidly adherent placenta. Two recent cases resulted in vessel dissection requiring vascular intervention. The last case resulted in a dissection of the femoral artery requiring thrombectomy. It was discussed that the sheath may actually be too large for the vessel and possibly causing the issue. The surgeons discussed herparinzring these patients in the future with the REBOA in place which doesn’t make a lot of sense to me in a patient with potentially uncontrolled hemorrhage. Have you or anyone else been using REBOA in this way? Has anyone seen this types of complications in the pregnant population?

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