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BOOK REVIEW
Year : 2012  |  Volume : 135  |  Issue : 4  |  Page : 568-569

WHO guidelines for the management of postpartum haemorrhage and retained placenta


Department of Obstetrics & Gynecology, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India

Date of Web Publication29-May-2012

Correspondence Address:
Vanita Jain
Department of Obstetrics & Gynecology, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Jain V. WHO guidelines for the management of postpartum haemorrhage and retained placenta. Indian J Med Res 2012;135:568-9

How to cite this URL:
Jain V. WHO guidelines for the management of postpartum haemorrhage and retained placenta. Indian J Med Res [serial online] 2012 [cited 2021 May 19];135:568-9. Available from: https://www.ijmr.org.in/text.asp?2012/135/4/568/96769

WHO guidelines for the management of postpartum haemorrhage and retained placenta (World Health Organization, Geneva) 2009. 55 pages. Price: US $ 15.00; in developing countries: CHF/US$ 10.50

ISBN 978-92-4-159851-4

Postpartum haemorrhage (PPH) is the most dreaded, rapid and leading cause of maternal death. On an average, it takes just two hours for PPH to kill. Thus, avoiding delays in diagnosis and treatment of haemorrhage soon after delivery can save many lives.

This publication provides evidence based management guidelines on safety, quality and usefulness of various interventions for the prevention and treatment of PPH. These guidelines are applicable to a setting where a woman is being managed by a health care worker in a medical facility.

The book is a result of a rigorous methodology and team effort. Staff from the WHO Departments of Reproductive Health and Research, Making Pregnancy Safer, and Essential Medicines and Pharmaceutical Policies drafted questions on interventions in the treatment of PPH. These questions were then reviewed by an international multidisciplinary panel of 144 experts, health workers and consumers. The evidence to answer these questions was further searched by the WHO Collaborating Centre, Centro Rosarino de Estudios Perinatales (CREP). The available evidence was reviewed and graded using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology. The evidence obtained from an array of published and unpublished material was then examined in depth by the technical consultation team to prepare recommendations.

A comprehensive summary of evidence for every important aspect of management of PPH is given followed by recommendations. To provide the correct perspective, a note on the quality of evidence and the strength of recommendation has also been added. The guidelines include "care pathways" or algorithms for management of PPH as a practical guide to step-wise approach for clinicians. These algorithms have been prepared after a detailed analysis of algorithms from various countries .The book also mentions the questions considered as high priority for research in international community. These will prove to be a useful guide for researchers in this field. A list of references for each question has also been provided.

The compiling of data in a FAQ format has given sufficient clarity to the subject. However, many aspects regarding the management of PPH remain elusive. The authors have themselves opined that only questions regarded as high priority by the panel have been dealt with.

These guidelines are a ready reference for the national policy makers, as the ground work of searching for evidence has been done meticulously. The recommendations emerge as an answer to the important aspects of management of PPH for the health care providers. The pull out on "Care pathways" for PPH could be pasted on the delivery room wall as a reminder for prompt action and constant vigilance of a mother who has just delivered. The document skillfully combines the science of hard facts as obtained by evidence with the art of clinical expertise.




 

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