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01-04-2012 | Maternal-Fetal Medicine

Uterine-sparing surgical management of postpartum hemorrhage: is it always effective?

Authors: Julie Blanc, Blandine Courbiere, Raoul Desbriere, Florence Bretelle, Léon Boubli, Claude D’Ercole, Xavier Carcopino

Published in: Archives of Gynecology and Obstetrics | Issue 4/2012

Abstract

Purpose

To further study the efficacy of uterine-sparing procedures based on triple uterine artery ligation (TUAL) possibly complemented with hemostatic multiple square suturing (HMSS) for the management of post-partum hemorrhage (PPH).

Methods

Cases of PPH occurring during cesarean section and treated, according to our institution guidelines, by TUAL possibly complemented with HMSS between 2000 and 2009 were retrospectively analyzed.

Results

Fifty-six patients were included; 13 (23.2%) had TUAL only, while 43 (76.8%) had additional HMSS performed. Surgical conservative management of PPH was effective in 51 (91.1%) cases. PPH due to placenta accreta, either unanticipated or after failure of conservative management, showed an independent and significant impact on the risk of failure of the procedure (AOR 15.07, 95% CI 1.12–201.9, p = 0.041).

Conclusion

Obstetricians should be aware that a higher risk of failure of the procedure is to be expected in cases of PPH due to placenta accreta. In such situation, to avoid any useless delay in management, our findings suggest that peripartum hysterectomy should be immediately considered.

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Title: Uterine-sparing surgical management of postpartum hemorrhage: is it always effective?
Authors: Julie Blanc
Blandine Courbiere
Raoul Desbriere
Florence Bretelle
Léon Boubli
Claude D’Ercole
Xavier Carcopino
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 4/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-011-2083-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Uterine-sparing surgical management of postpartum hemorrhage: is it always effective?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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