🗊Презентация The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide

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The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №1The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №2The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №3The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №4The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №5The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №6The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №7The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №8The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №9The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №10The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №11The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №12The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №13The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №14The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №15The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №16The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №17The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №18The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №19The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №20The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №21The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №22The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №23The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №24The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №25The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №26The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №27The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №28The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №29The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №30The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №31The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №32The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №33
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The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №1
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The global burden of postpartum haemorrhage The global burden of postpartum haemorrhage
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The global burden of postpartum haemorrhage The global burden of postpartum haemorrhage

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What is postpartum haemorrhage? Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide. Postpartum haemorrhage (PPH) is commonly defined as a blood loss of 500 ml or more within 24 hours after birth. It affects about 5% of all women giving birth around the world. Globally, nearly one quarter of all maternal deaths are associated with PPH. In most low-income countries, it is the main cause of maternal mortality.
Описание слайда:
What is postpartum haemorrhage? Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide. Postpartum haemorrhage (PPH) is commonly defined as a blood loss of 500 ml or more within 24 hours after birth. It affects about 5% of all women giving birth around the world. Globally, nearly one quarter of all maternal deaths are associated with PPH. In most low-income countries, it is the main cause of maternal mortality.

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New findings on uterotonics for PPH prevention 2. Uterotonics for PPH prevention
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New findings on uterotonics for PPH prevention 2. Uterotonics for PPH prevention

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New findings on uterotonics for PPH prevention 2. Uterotonics for PPH prevention
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New findings on uterotonics for PPH prevention 2. Uterotonics for PPH prevention

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A systematic approach The recommendations were updated according to the standards of the WHO handbook on guideline development
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A systematic approach The recommendations were updated according to the standards of the WHO handbook on guideline development

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GDG formulates the recommendations The Guideline Development Group (GDG) convened in September & October 2018 The GDG comprised 18 external experts and relevant stakeholders with expertise in research, guideline development, policy and programmes on PPH prevention and treatment.
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GDG formulates the recommendations The Guideline Development Group (GDG) convened in September & October 2018 The GDG comprised 18 external experts and relevant stakeholders with expertise in research, guideline development, policy and programmes on PPH prevention and treatment.

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What works? Efficacy and safety of uterotonics for PPH prevention uterotonic options vs placebo or no treatment 4. What are the updated WHO recommendations?
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What works? Efficacy and safety of uterotonics for PPH prevention uterotonic options vs placebo or no treatment 4. What are the updated WHO recommendations?

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Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination
Описание слайда:
Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination

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Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination
Описание слайда:
Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination

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Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination
Описание слайда:
Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination

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Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination
Описание слайда:
Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination

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Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination
Описание слайда:
Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination

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Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination
Описание слайда:
Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination

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Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination Injectable prostaglandins
Описание слайда:
Recommendation 1. The use of an effective uterotonic for the prevention of PPH during the third stage of labour is recommended for all births. To effectively prevent PPH, only one of the following uterotonics should be used: Oxytocin Carbetocin Misoprostol Ergometrine/methylergometrine Oxytocin and ergometrine fixed-dose combination Injectable prostaglandins

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How do we compare uterotonics to one another? 4. Which one: identifying a uterotonic of choice
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How do we compare uterotonics to one another? 4. Which one: identifying a uterotonic of choice

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The global burden of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, слайд №17
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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)
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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)

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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)
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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)

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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)
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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)

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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)
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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)

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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)
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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)

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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)
Описание слайда:
4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)

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4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)
Описание слайда:
4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference) 4. Which one: Summary of judgements comparing uterotonics to oxytocin (reference)

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Recommendation 2. In settings where multiple uterotonic options are available, oxytocin (10 IU, IM/IV) is the recommended uterotonic agent for the prevention of PPH for all births. Vaginal birth or caesarean section Skilled health personnel are required
Описание слайда:
Recommendation 2. In settings where multiple uterotonic options are available, oxytocin (10 IU, IM/IV) is the recommended uterotonic agent for the prevention of PPH for all births. Vaginal birth or caesarean section Skilled health personnel are required

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Recommendation 3. In settings where oxytocin is unavailable (or its quality cannot be guaranteed), the use of other injectable uterotonics (carbetocin, or if appropriate ergometrine/methylergometrine or oxytocin and ergometrine fixed-dose combination) or oral misoprostol is recommended. Vaginal birth or caesarean section Skilled health personnel are required
Описание слайда:
Recommendation 3. In settings where oxytocin is unavailable (or its quality cannot be guaranteed), the use of other injectable uterotonics (carbetocin, or if appropriate ergometrine/methylergometrine or oxytocin and ergometrine fixed-dose combination) or oral misoprostol is recommended. Vaginal birth or caesarean section Skilled health personnel are required

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Recommendation 4. In settings where skilled health personnel are not present to administer injectable uterotonics, the administration of misoprostol (either 400 µg or 600 µg PO) by community health care workers and lay health workers is recommended for the prevention of PPH. If skilled health personnel are not present or have not been trained to administer injectable uterotonics, oral misoprostol is preferred
Описание слайда:
Recommendation 4. In settings where skilled health personnel are not present to administer injectable uterotonics, the administration of misoprostol (either 400 µg or 600 µg PO) by community health care workers and lay health workers is recommended for the prevention of PPH. If skilled health personnel are not present or have not been trained to administer injectable uterotonics, oral misoprostol is preferred

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5. What’s new: wider scope, more evidence 5. What’s new: wider scope, more evidence
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5. What’s new: wider scope, more evidence 5. What’s new: wider scope, more evidence

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5. So what’s new: More recommendations, greater specificity 5. So what’s new: More recommendations, greater specificity
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5. So what’s new: More recommendations, greater specificity 5. So what’s new: More recommendations, greater specificity

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6. implementing the updated WHO recommendations 6. implementing the updated WHO recommendations
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6. implementing the updated WHO recommendations 6. implementing the updated WHO recommendations

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Implementation considerations Update clinical guidance Develop or revise existing clinical guidelines, protocols or job aids
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Implementation considerations Update clinical guidance Develop or revise existing clinical guidelines, protocols or job aids

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Implementation considerations Quality-certified uterotonics Regulatory, procurement and logistics processes that work
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Implementation considerations Quality-certified uterotonics Regulatory, procurement and logistics processes that work

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