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To evaluate the management process and the guidelines for management of
postpartum hemorrhage due to uterine atony at the General Hospital Vienna, Medical University Vienna. Material and Methods: A retrospective analysis was carried out on all 24 cases of postpartum
hemorrhage due to uterine atony with an estimated blood loss of more than 800
mL, in which standardized guidelines were obtained. We included all women who
gave birth at the General Hospital of Vienna, the Medical University Vienna,
during the period from January 1st 2003 and December 31st 2009 and who suffered blood loss 800 mL at minimum due to uterine atony.
Results: The guidelines were in use for 14% - 71%. The average blood loss of
the 24 cases with uterine atony was 1342 mL. Conclusion: The management process
of postpartum hemorrhage due to uterine atony deviates from the hospital’s
guidelines in many cases.
Hereditary diffuse gastric cancer is a rare, autosomal dominant hereditary cancer syndrome associated with germline mutations in CDH1 in which 60% - 80% of affected individuals develop advanced diffuse gastric cancer, many as young adults. At clinical presentation, ~90% of these malignancies represent advanced, surgically incurable disease. As such, presymptomatic identification of germline CDH1 mutation carriers followed by early prophylactic total gastrictomy is the sole effective management strategy available. DNA sequence analysis of the CDH1 gene to identify the affected germline allele is the diagnostic standard of care; however, CDH1’s relatively high frequency of polymorphisms and the limited amount of experience available regarding them dictate that many identified variants are, as yet, of unknown clinical significance. Given the dramatic consequences of inappropriately offered or withheld treatment, careful clinical selection of at-risk individuals is critical. To facilitate this, multiple groups have published screening criteria recommendations, and while there is disagreement regarding the optimal diagnostic approach, the most widely-used overlap to a considerable degree.