15 - 17 Morbidity from PPH can be severe with sequelae including organ failure, shock, edema, compartment syndrome, transfusion complications, thrombosis, acute respiratory distress syndrome, sepsis, anemia, intensive care, and prolonged hospitalization. 14 Multiple studies have suggested that many deaths associated with PPH could be prevented with prompt recognition and more timely and aggressive treatment. PPH is a leading cause of maternal mortality and morbidity worldwide and accounts for nearly one-quarter of all maternal pregnancy-related deaths. 12, 13ДЄdverse Outcomes Associated With Postpartum Hemorrhage studies found rising PPH rates were not explained by changes in risk factors (e.g., maternal age, cesarean birth, multiple gestation). 13 Factors underlying the increase remain unclear, and both recent U.S. study reported the incidence of severe PPH doubled from 1.9 percent in 1999 to 4.2 percent in 2008 (p < 0.0001). 7 - 11 In the United States, one study found that the incidence of PPH increased 26% from 1994 to 2006 (2.3% vs. 5 Multiple studies have noted an increase in PPH in high-resource countries, including the United States, Canada, Australia, Ireland, and Norway, since the 1990s. 5, 6 Prevalence differs by assessment method and ranges from 10.6 percent when measured by objective appraisal of blood loss to 7.2 percent when assessed with subjective techniques to 5.4 percent when assessment is unspecified. The overall prevalence of PPH worldwide is estimated to be 6 to 11 percent of births with substantial variation across regions. In addition, PPH may be described as third or fourth stage depending on whether it occurs before or after delivery of the placenta, respectively. 1 PPH is often classified as primary/immediate/early, occurring within 24 hours of birth, or secondary/delayed/late, occurring more than 24 hours post-birth to up to 12 weeks postpartum. Proposed alternate metrics for defining and diagnosing PPH include change in hematocrit, need for transfusion, rapidity of blood loss, and changes in vital signs, all of which are complicated by the urgent nature of the condition. 1 - 4 Moreover, average blood loss at birth frequently exceeds 500 or 1000 mL, 4 and symptoms of hemorrhage or shock from blood loss may be hidden by the normal plasma volume increases that occur during pregnancy. 1 Definitions vary, however, and diagnosis of PPH is subjective and often based on inaccurate estimates of blood loss. Nevertheless, comments from the JPO have indicated that the new PPH, if extended, would likely increase the limit of requests to more than 100 per year, but would limit the number of PPH requests filed by each applicant.Postpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 milliliters (mL) following vaginal birth and 1000 mL following cesarean. Although the PPH requests were submitted in April-May 2017 and most of the related patent applications were recently filed (11 of the 14 were filed in 2016 or 2017), two of them are already about to be patented, and five of them have received examination results, attesting to the effectiveness of this pilot PPH program.ДЄccording to an officer of the NOIP, the NOIP and JPO have not yet officially discussed what happens вЂњafter the pilot program,вЂќ i.e., whether the PPH program will be extended. Last year, Tilleke & Gibbins filed 14 of the 100 PPH requests received by the NOIP. In 2017, the second year of the pilot program, this limit was reached in just one month and 21 days (requests were accepted from April 3, 2017, to May 24, 2017), so advance preparation and timely filing are essential to ensuring your PPH request is accepted. The requests should be prepared well in advance so they can be filed in the morning of April 2, 2018.ДЄs previously reported, the NOIPвЂ™s PPH pilot program was designed to last from 2016 to 2018, and is strictly limited to 100 PPH requests per year. It has been reported that the National Office of Intellectual Property (NOIP) of Vietnam will begin accepting requests on April 2, 2018, for the final year of its Patent Prosecution Highway (PPH) pilot program with the Japan Patent Office (JPO).ДЄs the number of requests is limited, if you wish to file any PPH requests, please let us know as soon as possible.

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