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[Transfers for postpartum haemorrhage in a Reference center (Lariboisière hospital): our experience during two years
C Brugier1, P Desfeux, Y Delpech
1Service de gynécologie-obstétrique, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
Objectives:
The postpartum haemorrhage (PPH) is the main cause of maternal mortality and is responsible in France every year of a quarter of the maternal deaths. We realized a study on the transfers for postpartum haemorrhage in 2008 and 2009 in a Reference center (Lariboisière Hospital).
Patients And Methods:
It is a descriptive retrospective study over a period of two years, including all the patients cared for a postpartum haemorrhage.
Results:
Two hundred and ninety-nine patients were cared for a PPH in 2008 and 2009 at the hospital Lariboisière. For transferred patients, the average age of the patients was of 30.9 years with varying extremes from 16 to 43 years old. It was the first pregnancy for 45.4% of the patients, having given birth to singletons (90.3%) by natural way in 63.8% of the cases. The care on arrival to Lariboisière based on surveillance in recovery room in 71.4% of the cases. The rate of embolisation was 22.4% and was stable over these two periods.
Discussion And Conclusion:
A supervision in recovery room associated with measures of resuscitation and with use of prostaglandins is mostly sufficient for the most part of the care of the PPH. In case of persistent bleeding, the embolisation remains an excellent therapeutic option and a good alternative in the hysterectomy of haemostasis, which however has to keep its place in severe PPH.
