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Challenges in Managing Postpartum Hemorrhage in Resource-poor Countries

KAROSHI, MAHANTESH MD, MRCOG*; KEITH, LOUIS MD, PhD, ScD (Hon)

Clinical Obstetrics & Gynecology: June 2009 - Volume 52 - Issue 2 - pp 285-298
doi: 10.1097/GRF.0b013e3181a4f737
Obstetric Practice in the Third World

Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood.

*Department of Obstetrics and Gynecology, Kingston Hospital, Galsworthy Road, Kingston Upon Thames, Surrey, United Kingdom

Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

Correspondence: Louis Keith, MD, PhD, ScD (Hon), Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. E-mail: lgk395@northwestern.edu

Sources of Support: none.

© 2009 Lippincott Williams & Wilkins, Inc.