Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016)

. 2018 Apr 26;78(4):382–399. doi: 10.1055/a-0582-0122

Consensus-based Recommendation 3.E8
If risk factors are present, the following measures must be taken: Adequate venous access for every woman in labour, adequate intravenous access in case of complications of bleeding Uterotonics must be available (oxytocin, e.g. Syntocinon ^® ), prostaglandins (e.g. sulprostone: Nalador ^® ), misoprostol (Cytotec ^® , off-label use) Check logistics: Check availability of emergency laboratory tests (complete blood count, blood gas analysis [BGA], aPTT, prothrombin time [PT] or INR, antithrombin [AT], fibrinogen, possibly thromboelastography or thromboelastometry [ROTEM]) Obstetrician and anaesthesiologist must be on site, experienced obstetrician and experienced anaesthesiologist on call Check availability of blood products: cross-matching, ordering of packed red blood cells, fresh frozen plasma and platelets Check availability of haemostatic agents (tranexamic acid [Cyclokapron ^® ], fibrinogen [Haemocomplettan ^® ], factor XIII [Fibrogammin ^® ], recombinant activated factor VII a [rFVIIa, NovoSeven ^® , off-label use]).

Consensus-based Recommendation 3.E8

Expert consensus

Level of consensus +++

If risk factors are present, the following measures must be taken:

Adequate venous access for every woman in labour, adequate intravenous access in case of complications of bleeding
Uterotonics must be available (oxytocin, e.g. Syntocinon ^® ), prostaglandins (e.g. sulprostone: Nalador ^® ), misoprostol (Cytotec ^® , off-label use)
Check logistics:
- Check availability of emergency laboratory tests (complete blood count, blood gas analysis [BGA], aPTT, prothrombin time [PT] or INR, antithrombin [AT], fibrinogen, possibly thromboelastography or thromboelastometry [ROTEM])
- Obstetrician and anaesthesiologist must be on site, experienced obstetrician and experienced anaesthesiologist on call
- Check availability of blood products: cross-matching, ordering of packed red blood cells, fresh frozen plasma and platelets
- Check availability of haemostatic agents (tranexamic acid [Cyclokapron ^® ], fibrinogen [Haemocomplettan ^® ], factor XIII [Fibrogammin ^® ], recombinant activated factor VII a [rFVIIa, NovoSeven ^® , off-label use]).