Prise en charge obstétricale en cas d’hémorragie du post-partum qui persiste malgré les mesures initiales ou qui est sévère d’emblée, après accouchement par voie basse

Intraoperative adverse events associated with extremely preterm cesarean deliveries

“…The principal endpoint was a composite outcome, named “composite intraoperative adverse event,” defined by any intraoperative adverse event, including: classical uterine incision (because the use of classical incision leads to a cesarean delivery in the next pregnancy and therefore an increase in the global maternal morbidity rate), transplacental incision, difficulty in fetal extraction, postpartum hemorrhage defined by blood loss ≥500 mL [as defined by the World Health Organization and the French clinical guidelines for postpartum hemorrhages or need for transfusion (indication based on clinical and hematological signs, according to French guidelines ], and any injury of adjacent organs (gastrointestinal, urological or vascular). In the surgical reports at our institution, operators systematically and explicitly mention transplacental incisions, any difficulty in fetal extraction, and quantification of blood loss (assessed by weighing dressings and measuring the blood collected by intraoperative aspiration).…”

Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016)

“…In addition to tamponade strips, there are a number of different balloon tamponade systems available for uterine tamponade; their efficacy has been described in various publications and their use has the advantage of allowing the early detection of persistent bleeding 64 , 67 , 68 , 69 , 70 , 71 , 72 , 73 .…”

“…Zur Tamponade des Uterus stehen neben Tamponadestreifen verschiedene Ballonsysteme zur Verfügung, deren Effektivität in verschiedenen Publikationen nachgewiesen wurde und die den Vorteil einer frühzeitigen Erkennung einer persistierenden Blutung bieten 64 , 67 , 68 , 69 , 70 , 71 , 72 , 73 .…”

Tamponnement intra-utérin : description des pratiques et de la formation des internes

“…Le tamponnement intra-utérin par ballonnet spécifique est connu depuis 1999 (4). C'est une technique de deuxième ligne utilisée après échec des traitements utérotoniques (5). Son but est d'appliquer une pression interne en cas d'atonie utérine.…”