Surgical Approach to Postpartum Hemorrhage After Uterine Atony

Transvaginal hemostatic surgery may be a safe and efficacious treatment option for individuals with early postpartum hemorrhage from lower uterine segment atony.

Researchers conducted a retrospective clinical study from 2010 to 2019 at a tertiary perinatal university center. Included were 29,543 deliveries, of which 0.72% (n=215) had early postpartum hemorrhage. Of the individuals with early postpartum hemorrhage, 29.93% (n=44) were due to uterine atony.

The results indicated that hemostatic ligation was used in 72.72% of cases (n=32). Hemostatic ligation alone or combined with gauze or balloon tamponade (n=5) was highly effective in 84.09% of cases (n=37).

“Lower uterine segment atony should definitely be identified and understood as a clinical entity,” researchers concluded. “Transvaginal hemostatic approach for surgical treatment of lower uterine segment atony is accessible, minimally invasive, feasible, successful and lifesaving. All of the above-mentioned methods are of great importance in the prevention and treatment of obstetric shock, multiorgan failure, postpartum hysterectomy and finally vital for fertility preservation.”

—Leigh Precopio

Reference:

Habek D, Marton I, Prka M, Luetić AT, Vitić M, Jurković AM. Transvaginally surgically treatment of early postpartum hemorrhage caused by lower uterine segment. J Perinat Med. Published online May 9, 2022. doi:10.1515/jpm-2021-0686