Fertilité et grossesses après prise en charge invasive des hémorragies du postpartum

Capmas, P.; Picone, Olivier; Musset, D.; Frydman, René; Fernandez, H.

doi:10.1016/j.jgyn.2012.01.001

Cited by 11 publications

(3 citation statements)

References 30 publications

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“…Our study confirms these results with a similar secondary infertility rate for patients with UAE compared to controls. Additionally, the time to achieve pregnancy is almost doubled for patients with UAE, as also described by Capmas et al 14 . While the theory of an unfavorable endometrium post-UAE might explain this difference, the psychological impact of the PPH is more likely the key factor for this delay.…”

Section: Discussionmentioning

confidence: 61%

Gynecological, reproductive and sexual outcomes after uterine artery embolization for post-partum haemorrage

Eggel

Bernasconi

Quibel

et al. 2021

Sci Rep

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In this case control study, long-term gynecological, reproductive and sexual outcomes after uterine artery embolization (UAE) for postpartum hemorrhage (PPH) were evaluated. The study was performed in a single referral hospital for PPH in Lausanne from 2003 to 2013. Each woman whose delivery was complicated by PPH and treated by UAE was included, and compared to a control group of women whose delivery was uncomplicated. Cases were matched by maternal age, parity, ethnicity, year and mode of delivery, birth weight and gestational age in a 1–3 ratio. A total of 77 patients treated by UAE for PPH were identified in our obstetrical database. Among them, 63 were included and compared to 189 matched patients (no PPH). The mean interval time between UAE and this study was 8.1 years. Time to menstrual cycle recovery after delivery (3.9 vs 5.6 months, p = 0.66), spotting (7.9% vs 7.2%, p = 0.49), dysmenorrhea (25.4% vs 22.2%, p = 0.60) and amenorrhea (14.3% vs 12.2%, p = 0.66) were similar between the two groups. There was no difference in the FSFI score between the groups (23.2 ± 0.6 vs 23.8 ± 0.4; p = 0.41). However, the interval time to subsequent pregnancy was longer for patients after UAE than the control group (35 vs 18 months, p = 0.002). In case of pregnancy desire, the success rate was lower after UAE compared to controls (55% vs 93.5%, p < 0.001). The rate of PPH was higher in those with previous PPH (6.6% vs 36.4%, p = 0.010). Patients treated by UAE for PPH did not report higher rates of gynecological symptoms or sexual dysfunction compared to patients with uneventful deliveries. The inter-pregnancy interval was increased and the success rate was reduced. In subsequent pregnancies, a higher rate of PPH was observed in those that underwent UAE.

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Section: Discussionmentioning

confidence: 61%

Gynecological, reproductive and sexual outcomes after uterine artery embolization for post-partum haemorrage

Eggel

Bernasconi

Quibel

et al. 2021

Sci Rep

View full text Add to dashboard Cite

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“…In literature, we found no series reporting the results of hysteroscopy following PAL as the sole treatment for SPPH‐UA. In a monocentric, retrospective study of 23 patients, Capmas et al 27 reported that 87% of patients desiring pregnancy were pregnant within 44 months after an IIAL, which could show that an IIAL is not a causal factor for IUAd. A telephone survey of fertility after stepwise uterine devascularization as described by AbdRabbo 28 , without other associated procedures, compared three groups of patients 29 .…”

Section: Discussionmentioning

confidence: 99%

Hysteroscopy after conservative surgical treatment of severe postpartum hemorrhage due to uterine atony: A systematic literature review

Zouaghi

Chaouch

Sanchez³

et al. 2023

Intl J Gynecology & Obste

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The World Health Organization defines postpartum hemorrhage (PPH) as blood loss of at least 500 mL within 24 h following labor.Severe postpartum hemorrhage (SPPH) is defined as blood loss of 1000 mL in the same period. PPH affects around 2% of women who give birth and is responsible for nearly one-quarter of maternal deaths worldwide. 1 According to the French National Confidential Enquiry into Maternal Deaths conducted between 2013 and 2015, obstetric hemorrhage accounted for 21% of maternal deaths

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“… 104 With regards to pregnancy outcomes after UAE, prior studies have not shown an association between UAE and adverse pregnancy or fertility related outcomes. 102 , 105 A few publications have shown higher rates of preterm birth, fetal growth restriction, and especially placenta accreta spectrum in subsequent pregnancies following UAE. 106 UAE is not recommended for brisk, ongoing bleeding that would not allow time to accomplish embolization, or for the hemodynamically unstable patient, for whom definitive surgical intervention is recommended.…”

Section: Management Of Refractory Pphmentioning

confidence: 99%

Review of Current Insights and Therapeutic Approaches for the Treatment of Refractory Postpartum Hemorrhage

Liu¹,

Nathan²,

Sheen³

et al. 2023

IJWH

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Refractory postpartum hemorrhage (PPH) affects 10–20% of patients with PPH when they do not respond adequately to first-line treatments. These patients require second-line interventions, including three or more uterotonics, additional medications, transfusions, non-surgical treatments, and/or surgical intervention. Multiple studies have suggested that patients with refractory PPH have different clinical characteristics and causes of PPH when compared to patients who respond to first-line agents. This review highlights current insights into therapeutic approaches for the management of refractory PPH. Early management of refractory PPH relies on both hypovolemic resuscitation and achievement of hemostasis, with an emphasis on early blood product replacement and massive transfusion protocols. Transfusion needs can be more rapidly and accurately identified through point-of-care tests such as thromboelastography. Medical therapies for the treatment of refractory PPH involve treatment of both uterine atony as well as the underlying coagulopathy, with the use of tranexamic acid and adjunct therapies such as factor replacement. The principles guiding the management of refractory PPH include restoring normal uterine and pelvic anatomy, through the evaluation and management of retained products of conception, uterine inversion, and obstetric lacerations. Intrauterine vacuum-induced hemorrhage control devices are novel methods for the treatment of refractory PPH secondary to uterine atony, in addition to other uterine-sparing surgical procedures that are under investigation. Resuscitative endovascular balloon occlusion of the aorta can be considered for cases of critical refractory PPH, to prevent or decrease ongoing blood loss while definitive surgical interventions are performed. Finally, for patients with critical hemorrhage resulting in hemorrhagic shock, damage control resuscitation (a staged surgical approach focused on restoring normal physiologic recovery and maximizing tissue oxygenation prior to proceeding with definitive surgical management) has been shown to successfully control refractory PPH, with an overall mortality decrease for obstetric patients.

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Fertilité et grossesses après prise en charge invasive des hémorragies du postpartum

Cited by 11 publications

References 30 publications

Gynecological, reproductive and sexual outcomes after uterine artery embolization for post-partum haemorrage

Gynecological, reproductive and sexual outcomes after uterine artery embolization for post-partum haemorrage

Hysteroscopy after conservative surgical treatment of severe postpartum hemorrhage due to uterine atony: A systematic literature review

Review of Current Insights and Therapeutic Approaches for the Treatment of Refractory Postpartum Hemorrhage

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