{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:30:59Z","timestamp":1777890659351,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NPM"],"published-print":{"date-parts":[[2023,10,11]]},"abstract":"<jats:p>BACKGROUND: Hemorrhage anticipation and management has shifted significantly over the past decade due to evolution of data surrounding management of obstetric hemorrhage. Limited data exists which describe the practical use and clinical application of hemorrhage management. Our goal was to identify obstetric hemorrhage management patterns in a cohort of practicing Maternal Fetal Medicine physicians. METHODS: We administered a survey to Maternal Fetal Medicine (MFM) fellows and faculty that addressed the management of hemorrhage including risk assessment, uterotonic use, antifibrinolytic use, cell saver use, and abnormal placentation management. An email was sent out regarding the survey to a listserv of all Maternal Fetal Medicine fellow program coordinators to disseminate to their faculty and fellows. Eighty responses were obtained. RESULTS: A total of 78 surveys were analyzed. Participants preferred methylergonovine as a first line agent (n\u200a=\u200a57; 73%, n\u200a=\u200a62; 80%). Most participants would consider using cell salvage when also activating MTP (28, 48%) or during scheduled deliveries who are high risk of hemorrhage (40, 69%). Approximately a third of providers would use TXA (tranexamic acid) prophylactically (n\u200a=\u200a21; 28%). Only 26% of MFM fellows felt comfortable performing cesarean hysterectomy without Gynecologic Oncology. CONCLUSION: In comparison to prior reports, TXA use has increased substantially. Further, when looking at the management of abnormal placentation, the use of magnetic resonance imaging and embolization have both increased. Possibly due to the rise in centers of excellence for treatment of accreta spectrum disorders, Maternal Fetal Medicine fellows still feel largely unprepared to perform a cesarean hysterectomy without Gynecologic Oncology.<\/jats:p>","DOI":"10.3233\/npm-221189","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T11:16:26Z","timestamp":1694776586000},"page":"539-545","source":"Crossref","is-referenced-by-count":1,"title":["A survey evaluating practice pattern in management of obstetric hemorrhage"],"prefix":"10.1177","volume":"16","author":[{"given":"M.","family":"Kaur","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, George Washington University, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.M.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences at University of Pittsburgh, Division of Maternal-Fetal-Medicine, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.K.","family":"Ahmadzia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, George Washington University, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/NPM-221189_ref1","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists and the Society for Maternal\u2013 Fetal Medicine, Kilpatrick SK , Ecker JL Severe maternal morbidity: Screening and review. Am J Obstet Gynecol. 2016;215. https:\/\/doi.org\/10.1016\/j.ajog.2016.07.050","DOI":"10.1016\/j.ajog.2016.07.050"},{"key":"10.3233\/NPM-221189_ref2","first-page":"18","article-title":"A national update on rates of postpartum haemorrhage and related interventions","author":"Ahmadzia","year":"2020","journal-title":"Blood Transfus"},{"key":"10.3233\/NPM-221189_ref3","doi-asserted-by":"crossref","unstructured":"Main EK , Cape V , Abreo A , Vasher J , Woods A , Carpenter A , et al. Reduction of severe maternal morbidity from hemorrhage using a state perinatal quality collaborative. Am J Obstet Gynecol. 2017;216. https:\/\/doi.org\/10.1016\/j.ajog.2017.01.017","DOI":"10.1016\/j.ajog.2016.11.935"},{"key":"10.3233\/NPM-221189_ref4","first-page":"2","article-title":"Antifibrinolytic drugs for treating primary postpartum haemorrhage","author":"Shakur","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"10.3233\/NPM-221189_ref5","first-page":"389","article-title":"WOMAN: Reducing maternal deaths with tranexamic acid","author":"The Lancet","year":"2017","journal-title":"The Lancet"},{"key":"10.3233\/NPM-221189_ref6","first-page":"379","article-title":"Tranexamic acid for the prevention of blood loss after vaginal delivery","author":"Sentilhes","year":"2018","journal-title":"N Engl J Med"},{"key":"10.3233\/NPM-221189_ref7","first-page":"131","article-title":"Use of tranexamic acid to prevent postpartum hemorrhage in women undergoing vaginal delivery: A Meta-analysis [36O]","author":"Boyd","year":"2018","journal-title":"Obstet Gynecol"},{"key":"10.3233\/NPM-221189_ref8","doi-asserted-by":"crossref","first-page":"133","DOI":"10.3233\/NPM-16915119","article-title":"Obstetric hemorrhage survey: Attitudes and practices of maternal-fetal medicine fellows","volume":"9","author":"Ahmadzia","year":"2016","journal-title":"J Neonatal Perinatal Med"},{"key":"10.3233\/NPM-221189_ref9","first-page":"73","article-title":"Tranexamic acid for prevention and treatment of postpartum hemorrhage: An update on management and clinical outcomes","author":"Ahmadzia","year":"2018","journal-title":"Obstet Gynecol Surv"},{"issue":"4","key":"10.3233\/NPM-221189_ref10","doi-asserted-by":"crossref","first-page":"e168","DOI":"10.1097\/AOG.0000000000002351","article-title":"Practice bulletin No. 183: Postpartum Hemorrhage","volume":"130","author":"Committee on Practice Bulletins-Obstetrics","year":"2017","journal-title":"Obstet Gynecol"},{"key":"10.3233\/NPM-221189_ref11","first-page":"213","article-title":"Prevention and management of postpartum hemorrhage: A comparison of 4 national guidelines","author":"Dahlke","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"10.3233\/NPM-221189_ref12","first-page":"119","article-title":"Patterns of second-line uterotonic use in a large sample of hospitalizations for child birth in the United States: 2007-2014","author":"Bateman","year":"2014","journal-title":"Anesth Analg"},{"key":"10.3233\/NPM-221189_ref13","first-page":"121","article-title":"Cell salvage in obstetrics","author":"Goucher","year":"2015","journal-title":"Anesth Analg"},{"key":"10.3233\/NPM-221189_ref14","first-page":"17","article-title":"Cell salvage in obstetrics","author":"Allam","year":"2008","journal-title":"Int J Obstet Anesth"},{"key":"10.3233\/NPM-221189_ref15","first-page":"219","article-title":"Placenta Accreta Spectrum","author":"Cahill","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"10.3233\/NPM-221189_ref16","first-page":"24","article-title":"Is cell salvaged vaginal blood loss suitable for re-infusion?","author":"Teare","year":"2015","journal-title":"Int J Obstet Anesth"},{"key":"10.3233\/NPM-221189_ref17","first-page":"16","article-title":"Cell salvage for postpartum haemorrhage during vaginal delivery: A case series","author":"Lim","year":"2018","journal-title":"Blood Transfus"},{"key":"10.3233\/NPM-221189_ref18","first-page":"220","article-title":"Evidence-based guidelines for the management of abnormally invasive placenta: Recommendations from the International Society for Abnormally Invasive Placenta","author":"Collins","year":"2019","journal-title":"Am J Obstet Gynecol"}],"container-title":["Journal of Neonatal-Perinatal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/NPM-221189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:42:55Z","timestamp":1777614175000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.medra.org\/servlet\/aliasResolver?alias=iospress&doi=10.3233\/NPM-221189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,11]]},"references-count":18,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3233\/npm-221189","relation":{},"ISSN":["1934-5798","1878-4429"],"issn-type":[{"value":"1934-5798","type":"print"},{"value":"1878-4429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,11]]}}}