[Peri-partum hemorrhage: surgical management]

Area of Science:

• Obstetrics and Gynecology
• Surgical Management
• Maternal Health

Context:

• Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide.
• Despite advances in medical, obstetrical, and interventional radiology, surgical intervention remains critical in life-threatening PPH cases.
• Surgical decisions depend on hemorrhage cause, patient's hemodynamic status, available resources, and delivery type.

Purpose:

• To highlight the critical role of surgical techniques in managing severe postpartum hemorrhage.
• To emphasize the importance of considering patient-specific factors when selecting surgical approaches.
• To advocate for the adoption of newer, conservative surgical methods.

Summary:

• Surgery is essential for controlling severe postpartum hemorrhage when conservative measures are insufficient.
• Indications and approaches for surgical management must be individualized based on clinical factors.
• While hysterectomy and hypogastric artery ligation are established, simpler, less aggressive conservative techniques are now preferred.

Impact:

• Improved understanding of surgical indications and techniques for severe PPH.
• Potential for reduced maternal morbidity and mortality through timely and appropriate surgical intervention.
• Shift towards prioritizing conservative surgical options for better preservation of reproductive function.