A Survey of Current Treatment Practices for Postpartum Hemorrhage by Practicing Obstetricians and Hematologists

Objective: To identify current treatment strategies for postpartum hemorrhage used by obstetricians (OB/GYNs) and hematologists (HEMs). Study Design: We conducted a survey of OB/GYNs (n = 220) and HEMs (n = 30) to describe the characteristics of current treatment strategies for postpartum hemorrhage. Surveys were administered via a structured questionnaire on a secure internet website from 5 12 October 2009. Results: The majority of OB/GYN and HEM respondents were practicing in a community hospital environment (77%). Of the OB/GYNs, the majority practiced at hospitals with over 2000 deliveries per year (77%). A majority (58%) of OB/GYNs were affiliated with hospitals that lacked a massive transfusion protocol to treat severe postpartum hemorrhage. Subsequent to uterine massage and additional oxytocin, the majority of OB/GYNs (73%), preferred the administration of Methergine® as the next level of intervention for postpartum hemorrhage. There was considerable variability in response to specific treatment strategies for several hypothetical case scenarios; however, the large majority of OB/GYNs favored obstetrical procedures over interventional radiology or administration of rFVIIa. A large majority (77%) of physicians who are familiar with rRVIIa as treatment for postpartum hemorrhage reported being very satisfied with the agent for this indication. Conclusions: An established, systematic treatment strategy among OB/GYNs emerged only in the case of mild postpartum hemorrhage. Authorship equally shared. Corresponding author.