Postpartum Hemorrhage

Sign/Symptoms
Blood Pressure Below Normal (Hypotension) Heart or Pulse Rate Raised (Tachycardia) Labor Heavy Bleeding After Delivery

Drugs
Misoprostol

Treatments
Surgery Surgical Repair Hysterectomy Exploratory Laparotomy Arterial Embolisation Medical Procedure Bimanual Uterine Massage and Compression Confirm Placenta is Whole Tamponade Balloon Alternative Medicine Goldenseal (Hydrastis Canadensis) Weakly Against Low Evidence Medical Therapy Bimanual Uterine Massage and Compression Weakly in Favour Low Evidence Tamponade Balloon Weakly in Favour Low Evidence Arterial Embolisation Weakly in Favour Low Evidence Exploratory Laparotomy Weakly in Favour Low Evidence Hysterectomy Weakly in Favour Low Evidence Surgical Repair Weakly in Favour Low Evidence

Attributes
Gender = F

Further Tests
Activated Partial Thromboplastin Time (APTT) Plasma thromboplastin antecedent (Decreased) Aldosterone Concentration Test Aldosterone (Increased) Cerebrospinal Fluid Protein Concentration Cerebrospinal Fluid Total Protein (Increased) Cerebrospinal Fluid White Cell Differential Cerebrospinal Fluid Leukocytes (Increased) Cerebrospinal Fluid Monocyte Differential (Increased) haptoglobin (Hp) concentration haptoglobin (Hp) (Decreased) Heamatocrit (Hct) RBC Mass (Decreased) Hemoglobin (Hb) Concentration Hemoglobin (Hb) (Decreased) Lactic Acid Concentration Lactic Acid (Venous Blood) (Increased) Platelet Count Platelets (Increased) Red Blood Cell (RBC) Count Red Blood Cells (RBC) (Decreased) Red Blood Cell Distribution Width (RDW) Test Red Blood Distribution Width (RDW) (Increased) Renin Assay Renin (Increased) Reticulocyte Absolute Count Reticulocytes (Increased) Urine Volume Urine (Decreased)

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Goldenseal (Hydrastis Canadensis) [1, 2, 3, 4, 5, 6, 7, 8]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly against (There is insufficient evidence to support claims that Goldenseal helps to treat postpartum hemorrhage. More studies are needed. Goldenseal may produce toxic effects, including depression, constipation, rapid heartbeat, stomach pain, mouth ulcers and vomiting.)

Grade of Evidence: low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/goldenseal

3. http://nccam.nih.gov/health/goldenseal/

4. Tierra Michael (1998): The Way of Herbs. New York, Pocket Books

5. Grieve M. (1971): A Modern Herbal. New York, Dover Publications, Inc

6. Mills S. and Bone K. (2000): Principles and Practice of Phytotherapy. Philadelphia, Churchill Livingstone

7. Tice Raymond (1997): Goldenseal and Two of its constituent alkaloids: berberine and hydrastine Research Triangle Park, National Institute of Environmental Health Sciences, in Seiger E: Review of Toxilogical Literature

8. http://www.henriettesherbal.com/eclectic/ellingwood/hydrastis.html

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