A conservative approach to the management of postpartum haemorrhage due to low placental implantation

Abstract

DiscussionRepair of a vesico-vaginal fistula in pregnancy has not been reported in the literature. We were compelled to perform the repair because of her two miscarriages that could have been caused by the Obstetric case reports 439 J Obstet Gynaecol Downloaded from informahealthcare.com by University of California Irvine on 11/02/14For personal use only.

Antifibrinolytic therapy with tranexamic acid in pregnancy and postpartum

“…Four studies used tranexamic acid for antepartum bleeding [14,15,17,20]. In the study by Singh et al [20] tranexamic acid was also used to control postpartum bleeding in one patient.…”

“…Four studies used tranexamic acid for antepartum bleeding [14,15,17,20]. In the study by Singh et al [20] tranexamic acid was also used to control postpartum bleeding in one patient. Antepartum bleeding occurred after > 24 weeks of pregnancy (range 24 --40 weeks), causes of bleeding were placental abruption [14,17] and placenta previa [15,17,20].…”

“…In the study by Singh et al [20] tranexamic acid was also used to control postpartum bleeding in one patient. Antepartum bleeding occurred after > 24 weeks of pregnancy (range 24 --40 weeks), causes of bleeding were placental abruption [14,17] and placenta previa [15,17,20]. Walzman et al [15] reported placenta previa as cardinal cause of bleeding in 3 cases out of 12; in the remaining nine cases the etiology of bleeding was not reported or identified.…”

“…The indication was prophylaxis as a hemostatic agent to prevent bleeding during cervical conisation in 45 women [16]. In the remaining 343 women [14,15,17,20], tranexamic acid was used for management of antepartum hemorrhage (placental abruption, placenta previa and bleeding of unknown cause in 259, 71 and 13 women, respectively). Adverse effects were reported in the study by Lindoff et al [17].…”

“…Six observational nonrandomized studies [14][15][16][17][18][19] and one case series [20] were considered for inclusion in this review. Only one study was multicenter [17] and the remaining six were done in single institutions.…”