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Lhemorragie du post-partum, definie par un saignement de plus de 500 ml dans les 24 heures qui suivent laccouchement, est une complicationgrave engageant rapidement le pronostic vital de la femme. Sa prise en charge doit etre multidisciplinaire. Elle repose sur des protocoles de soins chronometres partages au sein des reseaux de soins. Sont realises en parallele les gestes obstetricaux (delivrance artificielle, revision uterine et de filiere), ladministration duterotoniques (ocytocine et prostaglandines), le remplissage vasculaire et la transfusion ainsi que le traitement des anomalies de lhemostase. Lhemostase mecanique fait appel a la ligature ou a lembolisation des arteres uterines et a lhysterectomie dhemostase en dernier recours. Les conditions du transfert dune patiente vers un centre de radiologie interventionnelle ou un service de reanimation doivent etre pesees en fonction des conditions hemodynamiques de la patiente.
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