Management of Postpartum Hemorrhage in Low-and Middle-Income Countries: Emergency Need for Updated Approach Due to Specific Circumstances, Resources, and Availabilities
Aimagambetova G. Bapayeva G. Sakhipova G. Terzic M.
1 December 2024Multidisciplinary Digital Publishing Institute (MDPI)
Journal of Clinical Medicine
2024#13Issue 23
Postpartum hemorrhage (PPH) represents a critical emergency condition and the principal cause of maternal morbidity and mortality worldwide. It encompasses excessive bleeding following childbirth, which can arise from various causes. Prompt recognition and management are essential to mitigate severe outcomes and ensure maternal safety. The incidence of PPH in low-and middle-income countries (LMICs) is higher than in developed countries. Healthcare systems in developing countries face multiple challenges that may impact PPH management at policy, facility, and community levels. The mentioned barriers could be addressed by providing an empowering environment via the implementation of supportive policies, access to PPH care, planning supplies, allying strategies, providing training, and utilization of guidelines and algorithms for PPH management. Evidence-based international guidelines should serve as an integral part of appropriate management. On the other hand, LMICs have limited opportunities to implement the proposed international algorithms and guidelines. Therefore, some amendments based on the resource/expertise availability should be considered at the specific clinical site. This review summarizes and updates the accumulated knowledge on postpartum hemorrhage, focusing on challenging management options in developing countries. In many LMICs, maternal morbidity and mortality linked to PPH were improved after the implementation of standardized protocols and timely and purposeful interventions. International support in healthcare professionals’ training, enhancing resources, and the provision of an adapted evidence-based approach could assist in improving the management of PPH in LMICs. Refining our understanding of specific local circumstances, international support in specialists’ training, and the provision of evidence-based approaches may assist in improving the management of PPH in LMICs and contribute to safer childbirth.
LMICs , maternal mortality , postpartum bleeding , postpartum hemorrhage , postpartum hemorrhage management
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Department of Surgery, School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan
Clinical Academic Department of Women’s Health, CF “University Medical Center”, Astana, 010000, Kazakhstan
Department General Practitioners, West Kazakhstan Medical University, Aktobe, 030000, Kazakhstan
Department of Surgery
Clinical Academic Department of Women’s Health
Department General Practitioners
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