Postpartum haemorrhage

Ramanathan, Gowri; Arulkumaran, Sabaratnam

doi:10.1016/j.curobgyn.2005.10.002

Cited by 27 publications

(12 citation statements)

References 4 publications

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“…Many publications have reported that placenta accreta has become the most common cause of intractable PPH 13–16. In our study, the most common cause of intractable PPH was uterine atony.…”

Section: Discussionsupporting

confidence: 50%

Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience

et al. 2012

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Background:The purpose of this study is to describe treatment alternatives to prevent postpartum hysterectomy after failure of conventional therapies. Prevention of hysterectomy was the main outcome studied.Materials and Methods:This is a retrospective study of 19 patients diagnosed to have intractable postpartum hemorrhage and not managed with medical treatment who were subsequently treated with operative interventions in our unit between January 2004 and January 2009. The cases were identified by review of medical records.Results:In the period under review, a total of 17,341 deliveries were conducted, out of which 19 women were managed for intractable PPH. The incidence of severe PPH unresponsive to standard medical treatment was 0.1%. The mean maternal age was 33.5±3.4 years (range 27–39 years). The mean gestational age was 38.3±1.3 weeks (range 37–41 weeks). Organ preserving surgery methods were utilized in all the patients with a success rate 78.9%. The mean duration of surgery was 95 minutes (range 50–130 minutes) and the mean hospital stay was for 5 days. The mean transfused blood volume was 2.4 units as packed red cells. Among these 19 cases, 4 cases were resorted to hysterectomy.Conclusions:In the presence of uncontrolled hemorrhage, this simple procedure should be tried before other complex treatment alternatives are undertaken. Our case series suggests that the combination of uterine artery ligation with B-Lynch sutures might be the best surgical approach because it preserves future fertility better than other methods and avoids high operative risks and morbidity.

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Section: Discussionsupporting

confidence: 50%

Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience

et al. 2012

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“…3 The four main causes of PPH are uterine atony genital tract trauma, retained placental tissue and maternal coagulation disorders. 4 Primary PPH prevention strategies include pharmacological methods (uterotonic agents such as oxytocin and ergometrine) and non-pharmacological techniques (eg. uterine massage).…”

Section: Introductionmentioning

confidence: 99%

The effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum haemorrhage: a double‐blind randomised controlled trial

Mirghafourvand

Mohammadalizadeh

Abbasalizadeh

et al. 2015

Aust NZ J Obst Gynaeco

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“…6 The majority of maternal deaths occur during first 4 hours of delivery, which indicates that they are consequence complications of the third stage of labor. 7 Caesarean section is considered as a risk factor for atonic PPH and the worldwide incidence of caesarean section rate became horrible figures. 6 Oxytocin is a widely used and effective first choice uterotonic agent in the universal prevention of PPH.…”

Section: Introductionmentioning

confidence: 99%

Carbetocin versus Oxytocin and Misoprostol in prevention of atonic post-partum hemorrhage in high risk patients planed for cesarean delivery

Ali

Nasr

Ahmed

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Post-partum hemorrhage prevention (PPH) is considered a major issue due to its effect on maternal morbidity and mortality. The objective of this study was to compare efficacy of Carbetocin in prevention of atonic post-partum hemorrhage in high risk patients undergoing elective caesarean section in comparison to Oxytocin and Misoprostol.Methods: 150 pregnant women prepared for elective caesarean section were classified into 3 groups; Group I (50 patients received Carbetocin 100 mg I.V infusion), Group II (50 patients received 20 IU of Oxytocin infusion on 1000 ml of normal saline solution) and Group III (50 cases received Misoprostol 400 µg per rectum immediately before induction of anaesthesia). Assessment of PPH and its degree was determined according to amount of blood loss during and for first 24 hours of caesarean delivery, also further need for haemostatic measures were also assessed.Results: There was a statistically significant difference in PPH among the three groups 6, 14 and 12% for group I, II and III respectively (P <0.001), major PPH was 0, 4 and 6% for the same groups respectively (P <0.001). The need for additional uterotonic agents was significantly lesser in Group I compared to Group II and III (2% versus 8 and 12% respectively P = 0.02) also the need for additional surgical measures was significantly lesser among the three groups (P= 0.00). The drop in Hb level and haematocrit value was significantly lesser in group I compared to group II& III (P <0.05). The need for blood transfusion was significantly lesser in Group I compared to group II and III (0% versus 12% p <0.0001)Conclusions: Carbetocin was superior to Oxytocin and Misoprostol in prevention of atonic PPH in high risk patients underwent elective caesarean delivery. Carbetocin should be administered for all cases undergoing elective CS and carry a risk factor for postpartum hemorrhage.

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Postpartum haemorrhage

Cited by 27 publications

References 4 publications

Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience

Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience

The effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum haemorrhage: a double‐blind randomised controlled trial

Carbetocin versus Oxytocin and Misoprostol in prevention of atonic post-partum hemorrhage in high risk patients planed for cesarean delivery

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