Editorials

Genetic contribution to postpartum haemorrhage

BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g5285 (Published 27 August 2014) Cite this as: BMJ 2014;349:g5285
  1. Yap-Seng Chong, associate professor1, acting executive director2, senior consultant3,
  2. Claudia Chi, associate consultant3,
  3. Joanna Dawn Holbrook, senior principal investigator2, adjunct associate professor4
  1. 1Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  2. 2Singapore Institute for Clinical Sciences (SICS), A*STAR, Singapore
  3. 3Department of Obstetrics and Gynaecology, National University Health System, Singapore
  4. 4Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  1. Correspondence to: Yap-Seng Chong, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore obgcys{at}nus.edu.sg

Taking a family history from all pregnant women could save lives

Childbirth can be hazardous. Without modern medical interventions, one in two hundred women died in childbirth in the United Kingdom as late as the 1930s.1 These alarming rates persist today in areas where resources are scarce and births are unattended by skilled health workers.2 Not every birth can be attended by a health worker or take place in a maternity unit, even in developed countries. The best we can do is to suggest that women at particular risk for postpartum haemorrhage, the leading cause of maternal mortality worldwide,2 should be managed in settings where interventions for excessive bleeding during childbirth are available and judiciously used. There is good evidence that use of oxytocin at delivery prevents primary postpartum haemorrhage3 and that various medical and surgical interventions, including timely blood transfusion, can prevent death from postpartum haemorrhage.4

In a linked article, Oberg and colleagues (doi:10.1136/bmj.g4984) give us some valuable new insights on how to identify women who are more likely to require these interventions.5 Currently, we do not know how to reliably stratify women at risk for postpartum haemorrhage. …

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