Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus
Resumen:
Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert's consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth. Design: Systematic review and three-stage modified Delphi expert consensus. Setting: International. Population: Panel of 22 global experts in PPH with diverse backgrounds, and gender, professional and geographic balance. Outcome measures: Agreement or disagreement on strategies for early detection and first response management of PPH at caesarean birth. Results: Experts agreed that the same PPH definition should apply to both vaginal and caesarean birth. For the intraoperative phase, the experts agreed that early detection should be accomplished via quantitative blood loss measurement, complemented by monitoring the woman's haemodynamic status; and that first response should be triggered once the woman loses at least 500 mL of blood with continued bleeding or when she exhibits clinical signs of haemodynamic instability, whichever occurs first. For the first response, experts agreed on immediate administration of uterotonics and tranexamic acid, examination to determine aetiology and rapid initiation of cause-specific responses. In the postoperative phase, the experts agreed that caesarean birth-related PPH should be detected primarily via frequently monitoring the woman's haemodynamic status and clinical signs and symptoms of internal bleeding, supplemented by cumulative blood loss assessment performed quantitatively or by visual estimation. Postoperative first response was determined to require an individualised approach. Conclusion: These agreed on proposed approaches could help improve the detection of PPH in the intraoperative and postoperative phases of caesarean birth and the first response management of intraoperative PPH. Determining how best to implement these strategies is a critical next step.
| 2024 | |
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Clinical decision-making Maternal medicine Obstetrics Postpartum period Systematic review EMBARAZO TÉCNICA DELPHI EPIDEMIOLOGÍA CESÁREA DIAGNÓSTICO PRECOZ MUJERES TERAPÉUTICA USOS TERAPÉUTICOS ÁCIDO TRANEXÁMICO HEMORRAGIA POSPARTO EFECTOS ADVERSOS A LARGO PLAZO |
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| Inglés | |
| Universidad de la República | |
| COLIBRI | |
| https://hdl.handle.net/20.500.12008/56433 | |
| Acceso abierto | |
| Licencia Creative Commons Atribución (CC - By 4.0) |
| _version_ | 1877555280825286656 |
|---|---|
| author | Pingray, Verónica |
| author2 | Williams, Caitlin R. Al-Beity, Fadhlun M. Alwy Sosa, Claudio |
| author2_role | author author author |
| author_facet | Pingray, Verónica Williams, Caitlin R. Al-Beity, Fadhlun M. Alwy Sosa, Claudio |
| author_role | author |
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| dc.contributor.filiacion.none.fl_str_mv | Pingray Verónica, Instituto de Efectividad Clínica y Sanitaria (Argentina) Williams Caitlin R., University of North Carolina (E.E.U.U.). Chapel Hill Gillings School of Global Public Health. Department of Maternal and Child Health; Instituto de Efectividad Clínica y Sanitaria (Argentina) Al-Beity Fadhlun M. Alwy, Muhimbili University of Health and Allied Sciences (Tanzania). Department of Obstetrics and Gynaecology; Karolinska Institute (Suecia). Department of Global Public Health Sosa Claudio, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de Obstetricia y Ginecología |
| dc.creator.none.fl_str_mv | Pingray, Verónica Williams, Caitlin R. Al-Beity, Fadhlun M. Alwy Sosa, Claudio |
| dc.date.accessioned.none.fl_str_mv | 2026-08-21T15:49:15Z |
| dc.date.available.none.fl_str_mv | 2026-08-21T15:49:15Z |
| dc.date.issued.none.fl_str_mv | 2024 |
| dc.description.abstract.none.fl_txt_mv | Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert's consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth. Design: Systematic review and three-stage modified Delphi expert consensus. Setting: International. Population: Panel of 22 global experts in PPH with diverse backgrounds, and gender, professional and geographic balance. Outcome measures: Agreement or disagreement on strategies for early detection and first response management of PPH at caesarean birth. Results: Experts agreed that the same PPH definition should apply to both vaginal and caesarean birth. For the intraoperative phase, the experts agreed that early detection should be accomplished via quantitative blood loss measurement, complemented by monitoring the woman's haemodynamic status; and that first response should be triggered once the woman loses at least 500 mL of blood with continued bleeding or when she exhibits clinical signs of haemodynamic instability, whichever occurs first. For the first response, experts agreed on immediate administration of uterotonics and tranexamic acid, examination to determine aetiology and rapid initiation of cause-specific responses. In the postoperative phase, the experts agreed that caesarean birth-related PPH should be detected primarily via frequently monitoring the woman's haemodynamic status and clinical signs and symptoms of internal bleeding, supplemented by cumulative blood loss assessment performed quantitatively or by visual estimation. Postoperative first response was determined to require an individualised approach. Conclusion: These agreed on proposed approaches could help improve the detection of PPH in the intraoperative and postoperative phases of caesarean birth and the first response management of intraoperative PPH. Determining how best to implement these strategies is a critical next step. |
| dc.description.es.fl_txt_mv | Verónica Pingray 1, Caitlin R Williams 2 3, Fadhlun M Alwy Al-Beity 4 5, Edgardo Abalos 6 7, Sabaratnam Arulkumaran 8, Alejandro Blumenfeld 2 9, Brendan Carvalho 10, Catherine Deneux-Tharaux 11, Soo Downe 12 13, Alexandre Dumont 14, Maria Fernanda Escobar 15 16, Cherrie Evans 17, Sue Fawcus 18, Hadiza S Galadanci 19 20, Diem-Tuyet Thi Hoang 21, G Justus Hofmeyr 22 23, Caroline Homer 24, Ayodele G Lewis 25, Tippawan Liabsuetrakul 26 27, Pisake Lumbiganon 28, Elliott K Main 29 30, Judith Maua 31, Francis G Muriithi 32 33, Ashraf Fawzy Nabhan 34, Inês Nunes 35 36 37, Vanesa Ortega 38, Thuan N Q Phan 39 40, Zahida P Qureshi 41, Claudio Sosa 42 43, John Varallo 44, Andrew D Weeks 39 45, Mariana Widmer 46, Olufemi T Oladapo 46, Ioannis Gallos 46, Arri Coomarasamy 32, Suellen Miller 47, Fernando Althabe 46 Affiliations 1Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina vpingray@iecs.org.ar. 2Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina. 3Department of Maternal & Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA. 4Department of Obstetrics & Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania. 5Department of Global Public Health, Karolinska Institute, Stockholm, Sweden. 6Maternidad Martin, Secretaría de Salud Pública de la Municipalidad de Rosario, Rosario, Santa Fe, Argentina. 7Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina. 8Department of Obstetrics & Gynaecology, St George's Hospital, London, UK. 9Department of Public Health, Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina. 10Stanford University School of Medicine, Stanford, California, USA. 11Obstetrical Perinatal and Pediatric Epidemiology Research team, Centre for Research in Statistics and Epidemiology (CRESS) Université Paris Cité INSERM, Paris, France. 12Research in Childbirth and Health, University of Central Lancashire, Preston, UK. 13THRIVE Centre, School of Heath and Community Studies, University of Central Lancashire, Preston, UK. 14CEPED, Université Paris Cité, IRD, INSERM, Paris, France. 15Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cali, Colombia. 16Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia. 17Technical Leadership & Innovations Office, Jhpiego/USA, Baltimore, Maryland, USA. 18Department of Obstetrics and Gynaecology, University of Cape Town, Rondebosch, South Africa. 19Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria. 20Africa Center of Excellence for Population Health and Policy, Bayero University Kano, Kano, Nigeria. 21Obstetrics and Gynecology, Hung Vuong Hospital, Ho Chi Minh, Viet Nam. 22Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana. 23Effective Care Research Unit, University of the Witwatersrand, Johannesburg and Walter Sisulu University, Mthatha, South Africa. 24Burnet Institute, Melbourne, Victoria, Australia. 25Amherst College, Amherst, Massachusetts, USA. 26Department of Epidemiology, Prince of Songkla University, Hat Yai, Thailand. 27Department of Obstetrics & Gynecology, Prince of Songkla University, Hat Yai, Thailand. 28Department of Obstetrics and Gynaecology, Khon Kaen University, Khon Kaen, Thailand. 29Department of Obstetrics & Gynecology-Maternal Fetal Medicine, Stanford University, Stanford, California, USA. 30California Maternal Quality Care Collaborative, Standford, California, USA. 31Liverpool School of Tropical Medicine, Nairobi, Kenya. 32Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK. 33Department of Obstetrics and Gynaecology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK. 34Department of Obstetrics & Gynecology, Ain Shams University Faculty of Medicine, Cairo, Egypt. 35Department of Obstetrics and Gynaecology, Gaia/ Espinho Local Health Unit, Vila Nova de Gaia, Portugal. 36RISE-HEALTH - CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal. 37Faculty of Medicine, University of Porto, Porto, Portugal. 38Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina. 39Department of Women's and Children's Health, University of Liverpool, Liverpool, UK. 40Department of Delivery, Tu Du Hospital, Ho Chi Minh City, Viet Nam. 41University of Nairobi Department of Obstetrics and Gynecology, Nairobi, Kenya. 42Woman and Reproduction Health Unit at Maternal Health at the Latin American Center of Perinatology (CLAP/WR), Pan American Health Organization, Montevideo, District of Columbia, USA. 43Department of Obstetrics and Gynecology, School of Medicine, Universidad de la República Uruguay, Montevideo, Uruguay. 44Women's Health, Global Surgery Foundation, Washington, District of Columbia, USA. 45Liverpool Women's Hospital, Liverpool, UK. 46UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland. 47Bixby Center for Global reproductive Health, University of California San Francisco, San Francisco, California, USA. |
| dc.format.extent.es.fl_str_mv | 12 p. |
| dc.format.mimetype.es.fl_str_mv | application/pdf |
| dc.identifier.citation.es.fl_str_mv | Pingray V, Williams C, Al-Beity F y otros. Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus [en línea].. BMJ Open. 2024;14(5) 12 p. |
| dc.identifier.doi.none.fl_str_mv | 10.1136/bmjopen-2023-079713 |
| dc.identifier.eissn.none.fl_str_mv | 2044-6055 |
| dc.identifier.uri.none.fl_str_mv | https://hdl.handle.net/20.500.12008/56433 |
| dc.language.iso.none.fl_str_mv | en eng |
| dc.publisher.es.fl_str_mv | BMJ Publishing Group |
| dc.relation.none.fl_str_mv | BMJ Open. 2024;14(5) |
| dc.rights.license.none.fl_str_mv | Licencia Creative Commons Atribución (CC - By 4.0) |
| dc.rights.none.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.source.none.fl_str_mv | reponame:COLIBRI instname:Universidad de la República instacron:Universidad de la República |
| dc.subject.es.fl_str_mv | Clinical decision-making Maternal medicine Obstetrics Postpartum period Systematic review |
| dc.subject.other.es.fl_str_mv | EMBARAZO TÉCNICA DELPHI EPIDEMIOLOGÍA CESÁREA DIAGNÓSTICO PRECOZ MUJERES TERAPÉUTICA USOS TERAPÉUTICOS ÁCIDO TRANEXÁMICO HEMORRAGIA POSPARTO EFECTOS ADVERSOS A LARGO PLAZO |
| dc.title.none.fl_str_mv | Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| dc.type.es.fl_str_mv | Artículo |
| dc.type.none.fl_str_mv | info:eu-repo/semantics/article |
| dc.type.version.none.fl_str_mv | info:eu-repo/semantics/publishedVersion |
| description | Verónica Pingray 1, Caitlin R Williams 2 3, Fadhlun M Alwy Al-Beity 4 5, Edgardo Abalos 6 7, Sabaratnam Arulkumaran 8, Alejandro Blumenfeld 2 9, Brendan Carvalho 10, Catherine Deneux-Tharaux 11, Soo Downe 12 13, Alexandre Dumont 14, Maria Fernanda Escobar 15 16, Cherrie Evans 17, Sue Fawcus 18, Hadiza S Galadanci 19 20, Diem-Tuyet Thi Hoang 21, G Justus Hofmeyr 22 23, Caroline Homer 24, Ayodele G Lewis 25, Tippawan Liabsuetrakul 26 27, Pisake Lumbiganon 28, Elliott K Main 29 30, Judith Maua 31, Francis G Muriithi 32 33, Ashraf Fawzy Nabhan 34, Inês Nunes 35 36 37, Vanesa Ortega 38, Thuan N Q Phan 39 40, Zahida P Qureshi 41, Claudio Sosa 42 43, John Varallo 44, Andrew D Weeks 39 45, Mariana Widmer 46, Olufemi T Oladapo 46, Ioannis Gallos 46, Arri Coomarasamy 32, Suellen Miller 47, Fernando Althabe 46 |
| eu_rights_str_mv | openAccess |
| format | article |
| id | COLIBRI_a186b61c2e6d2745f16792e275e33c6e |
| identifier_str_mv | Pingray V, Williams C, Al-Beity F y otros. Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus [en línea].. BMJ Open. 2024;14(5) 12 p. 10.1136/bmjopen-2023-079713 2044-6055 |
| instacron_str | Universidad de la República |
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| language | eng |
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| spelling | Pingray Verónica, Instituto de Efectividad Clínica y Sanitaria (Argentina)Williams Caitlin R., University of North Carolina (E.E.U.U.). Chapel Hill Gillings School of Global Public Health. Department of Maternal and Child Health; Instituto de Efectividad Clínica y Sanitaria (Argentina)Al-Beity Fadhlun M. Alwy, Muhimbili University of Health and Allied Sciences (Tanzania). Department of Obstetrics and Gynaecology; Karolinska Institute (Suecia). Department of Global Public HealthSosa Claudio, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de Obstetricia y Ginecología2026-08-21T15:49:15Z2026-08-21T15:49:15Z2024Pingray V, Williams C, Al-Beity F y otros. Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus [en línea].. BMJ Open. 2024;14(5) 12 p.https://hdl.handle.net/20.500.12008/5643310.1136/bmjopen-2023-0797132044-6055Verónica Pingray 1, Caitlin R Williams 2 3, Fadhlun M Alwy Al-Beity 4 5, Edgardo Abalos 6 7, Sabaratnam Arulkumaran 8, Alejandro Blumenfeld 2 9, Brendan Carvalho 10, Catherine Deneux-Tharaux 11, Soo Downe 12 13, Alexandre Dumont 14, Maria Fernanda Escobar 15 16, Cherrie Evans 17, Sue Fawcus 18, Hadiza S Galadanci 19 20, Diem-Tuyet Thi Hoang 21, G Justus Hofmeyr 22 23, Caroline Homer 24, Ayodele G Lewis 25, Tippawan Liabsuetrakul 26 27, Pisake Lumbiganon 28, Elliott K Main 29 30, Judith Maua 31, Francis G Muriithi 32 33, Ashraf Fawzy Nabhan 34, Inês Nunes 35 36 37, Vanesa Ortega 38, Thuan N Q Phan 39 40, Zahida P Qureshi 41, Claudio Sosa 42 43, John Varallo 44, Andrew D Weeks 39 45, Mariana Widmer 46, Olufemi T Oladapo 46, Ioannis Gallos 46, Arri Coomarasamy 32, Suellen Miller 47, Fernando Althabe 46Affiliations 1Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina vpingray@iecs.org.ar. 2Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina. 3Department of Maternal & Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA. 4Department of Obstetrics & Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania. 5Department of Global Public Health, Karolinska Institute, Stockholm, Sweden. 6Maternidad Martin, Secretaría de Salud Pública de la Municipalidad de Rosario, Rosario, Santa Fe, Argentina. 7Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina. 8Department of Obstetrics & Gynaecology, St George's Hospital, London, UK. 9Department of Public Health, Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina. 10Stanford University School of Medicine, Stanford, California, USA. 11Obstetrical Perinatal and Pediatric Epidemiology Research team, Centre for Research in Statistics and Epidemiology (CRESS) Université Paris Cité INSERM, Paris, France. 12Research in Childbirth and Health, University of Central Lancashire, Preston, UK. 13THRIVE Centre, School of Heath and Community Studies, University of Central Lancashire, Preston, UK. 14CEPED, Université Paris Cité, IRD, INSERM, Paris, France. 15Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cali, Colombia. 16Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia. 17Technical Leadership & Innovations Office, Jhpiego/USA, Baltimore, Maryland, USA. 18Department of Obstetrics and Gynaecology, University of Cape Town, Rondebosch, South Africa. 19Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria. 20Africa Center of Excellence for Population Health and Policy, Bayero University Kano, Kano, Nigeria. 21Obstetrics and Gynecology, Hung Vuong Hospital, Ho Chi Minh, Viet Nam. 22Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana. 23Effective Care Research Unit, University of the Witwatersrand, Johannesburg and Walter Sisulu University, Mthatha, South Africa. 24Burnet Institute, Melbourne, Victoria, Australia. 25Amherst College, Amherst, Massachusetts, USA. 26Department of Epidemiology, Prince of Songkla University, Hat Yai, Thailand. 27Department of Obstetrics & Gynecology, Prince of Songkla University, Hat Yai, Thailand. 28Department of Obstetrics and Gynaecology, Khon Kaen University, Khon Kaen, Thailand. 29Department of Obstetrics & Gynecology-Maternal Fetal Medicine, Stanford University, Stanford, California, USA. 30California Maternal Quality Care Collaborative, Standford, California, USA. 31Liverpool School of Tropical Medicine, Nairobi, Kenya. 32Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK. 33Department of Obstetrics and Gynaecology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK. 34Department of Obstetrics & Gynecology, Ain Shams University Faculty of Medicine, Cairo, Egypt. 35Department of Obstetrics and Gynaecology, Gaia/ Espinho Local Health Unit, Vila Nova de Gaia, Portugal. 36RISE-HEALTH - CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal. 37Faculty of Medicine, University of Porto, Porto, Portugal. 38Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina. 39Department of Women's and Children's Health, University of Liverpool, Liverpool, UK. 40Department of Delivery, Tu Du Hospital, Ho Chi Minh City, Viet Nam. 41University of Nairobi Department of Obstetrics and Gynecology, Nairobi, Kenya. 42Woman and Reproduction Health Unit at Maternal Health at the Latin American Center of Perinatology (CLAP/WR), Pan American Health Organization, Montevideo, District of Columbia, USA. 43Department of Obstetrics and Gynecology, School of Medicine, Universidad de la República Uruguay, Montevideo, Uruguay. 44Women's Health, Global Surgery Foundation, Washington, District of Columbia, USA. 45Liverpool Women's Hospital, Liverpool, UK. 46UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland. 47Bixby Center for Global reproductive Health, University of California San Francisco, San Francisco, California, USA.Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert's consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth. Design: Systematic review and three-stage modified Delphi expert consensus. Setting: International. Population: Panel of 22 global experts in PPH with diverse backgrounds, and gender, professional and geographic balance. Outcome measures: Agreement or disagreement on strategies for early detection and first response management of PPH at caesarean birth. Results: Experts agreed that the same PPH definition should apply to both vaginal and caesarean birth. For the intraoperative phase, the experts agreed that early detection should be accomplished via quantitative blood loss measurement, complemented by monitoring the woman's haemodynamic status; and that first response should be triggered once the woman loses at least 500 mL of blood with continued bleeding or when she exhibits clinical signs of haemodynamic instability, whichever occurs first. For the first response, experts agreed on immediate administration of uterotonics and tranexamic acid, examination to determine aetiology and rapid initiation of cause-specific responses. In the postoperative phase, the experts agreed that caesarean birth-related PPH should be detected primarily via frequently monitoring the woman's haemodynamic status and clinical signs and symptoms of internal bleeding, supplemented by cumulative blood loss assessment performed quantitatively or by visual estimation. Postoperative first response was determined to require an individualised approach. Conclusion: These agreed on proposed approaches could help improve the detection of PPH in the intraoperative and postoperative phases of caesarean birth and the first response management of intraoperative PPH. Determining how best to implement these strategies is a critical next step.Submitted by Almiñana María Cecilia (marialminana@gmail.com) on 2026-08-20T16:53:25Z No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Strategies for optimising early detection.pdf: 5333982 bytes, checksum: 99a334c1a446987389a5a891915e6716 (MD5)Approved for entry into archive by Almiñana María Cecilia (marialminana@gmail.com) on 2026-08-20T18:12:16Z (GMT) No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Strategies for optimising early detection.pdf: 5333982 bytes, checksum: 99a334c1a446987389a5a891915e6716 (MD5)Made available in DSpace by Luna Fabiana (fabiana.luna@seciu.edu.uy) on 2026-08-21T15:49:15Z (GMT). No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Strategies for optimising early detection.pdf: 5333982 bytes, checksum: 99a334c1a446987389a5a891915e6716 (MD5) Previous issue date: 202412 p.application/pdfenengBMJ Publishing GroupBMJ Open. 2024;14(5)Las obras depositadas en el Repositorio se rigen por la Ordenanza de los Derechos de la Propiedad Intelectual de la Universidad de la República.(Res. Nº 91 de C.D.C. de 8/III/1994 – D.O. 7/IV/1994) y por la Ordenanza del Repositorio Abierto de la Universidad de la República (Res. Nº 16 de C.D.C. de 07/10/2014)info:eu-repo/semantics/openAccessLicencia Creative Commons Atribución (CC - By 4.0)Clinical decision-makingMaternal medicineObstetricsPostpartum periodSystematic reviewEMBARAZOTÉCNICA DELPHIEPIDEMIOLOGÍACESÁREADIAGNÓSTICO PRECOZMUJERESTERAPÉUTICAUSOS TERAPÉUTICOSÁCIDO TRANEXÁMICOHEMORRAGIA POSPARTOEFECTOS ADVERSOS A LARGO PLAZOStrategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensusArtículoinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionreponame:COLIBRIinstname:Universidad de la Repúblicainstacron:Universidad de la RepúblicaPingray, VerónicaWilliams, Caitlin R.Al-Beity, Fadhlun M. 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- Universidad de la Repúblicafalse |
| spellingShingle | Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus Pingray, Verónica Clinical decision-making Maternal medicine Obstetrics Postpartum period Systematic review EMBARAZO TÉCNICA DELPHI EPIDEMIOLOGÍA CESÁREA DIAGNÓSTICO PRECOZ MUJERES TERAPÉUTICA USOS TERAPÉUTICOS ÁCIDO TRANEXÁMICO HEMORRAGIA POSPARTO EFECTOS ADVERSOS A LARGO PLAZO |
| status_str | publishedVersion |
| title | Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_full | Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_fullStr | Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_full_unstemmed | Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_short | Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| title_sort | Strategies for optimising early detection and obstetric first response management of postpartum haemorrhage at caesarean birth: a modified Delphi-based international expert consensus |
| topic | Clinical decision-making Maternal medicine Obstetrics Postpartum period Systematic review EMBARAZO TÉCNICA DELPHI EPIDEMIOLOGÍA CESÁREA DIAGNÓSTICO PRECOZ MUJERES TERAPÉUTICA USOS TERAPÉUTICOS ÁCIDO TRANEXÁMICO HEMORRAGIA POSPARTO EFECTOS ADVERSOS A LARGO PLAZO |
| url | https://hdl.handle.net/20.500.12008/56433 |
