Emerging technology for early detection and management of postpartum hemorrhage to prevent morbidity

Megan G. Lord, Joaquin A. Calderon, Homa K. Ahmadzia, Luis D. Pacheco

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Despite advances in hemorrhage detection and management, postpartum hemorrhage remains the single leading cause of maternal death worldwide. Within the United States, hemorrhage is the leading cause of maternal death on the day of delivery and within the first week after delivery. Blood transfusion after hemorrhage represents a large proportion of severe maternal morbidity during and after delivery. Blood loss during delivery has historically been assessed visually by inspecting soiled pads, linens, and laparotomy sponges. These methods underestimate the volume of blood loss by as much as 40%, becoming increasingly inaccurate as blood loss increases. Young, healthy obstetrical patients compensate for blood loss via peripheral vasoconstriction, maintaining heart rate and blood pressure in a normal range until over 1 L of blood has been lost. A significant decrease in blood pressure along with marked tachycardia (>120 bpm) may not be seen until 30% to 40% of blood volume has been lost, or 2.0 to 2.6 L in a healthy term pregnant patient, after which the patient may rapidly decompensate. In resource-poor settings especially, the narrow window between the emergence of significant vital sign abnormalities and clinical decompensation may prove catastrophic. Once hemorrhage is detected, decisions regarding blood product transfusion are routinely made on the basis of inaccurate estimates of blood loss, placing patients at risk of underresuscitation (increasing the risk of hemorrhagic shock and end-organ damage) or overresuscitation (increasing the risk of transfusion reaction, fluid overload, and alloimmunization). We will review novel technologies that have emerged to assist both in the early and accurate detection of postpartum hemorrhage and in decisions regarding blood product transfusion.

Original languageEnglish (US)
Article number100742
JournalAmerican journal of obstetrics & gynecology MFM
Issue number2
StatePublished - Feb 2023


  • compensatory reserve
  • postpartum hemorrhage
  • postpartum hemorrhage detection
  • rotational thromboelastometry
  • thromboelastography
  • thromboelastometry
  • viscoelastic hemostasis assays

ASJC Scopus subject areas

  • Obstetrics and Gynecology


Dive into the research topics of 'Emerging technology for early detection and management of postpartum hemorrhage to prevent morbidity'. Together they form a unique fingerprint.

Cite this