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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-04

AUTHORS

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

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. More... »

PAGES

925-930

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00404-011-2083-7

DOI

http://dx.doi.org/10.1007/s00404-011-2083-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1026953527

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21932086


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42 schema:description 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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