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Laparoscopic Hemostasis of Intractable Delayed Postpartum Hemorrhage
Dipak Limbachiya1, Mangirish Kenkre1, Siddharth Shah1
1Department of Gynecology, Eva Women's Hospital, Ahmedabad, IND.
Cureus
|March 1, 2021
Summary
Severe postpartum hemorrhage (PPH) unresponsive to standard treatments can be effectively managed with laparoscopic surgery. These minimally invasive techniques offer successful hemostasis for intractable PPH cases.
Area of Science:
- Obstetrics and Gynecology
- Minimally Invasive Surgery
Background:
- Postpartum hemorrhage (PPH) poses significant risks, especially when requiring repeat surgery.
- The causes of severe, spontaneous PPH in stable patients are not well understood.
- Secondary PPH is defined as bleeding after 24 hours postpartum until the sixth week.
Observation:
- Three cases of severe, diffuse PPH were unresponsive to conventional hemostatic methods.
- All patients were hemodynamically stable.
- Laparoscopic interventions were successfully employed for hemostasis.
Findings:
- Case 1: Excision of cervical stump bleeding.
- Case 2: Bilateral uterine artery ligation and laparoscopic hysterectomy.
- Case 3: Bilateral internal iliac artery ligation.
Implications:
- Laparoscopic surgery provides effective management for refractory postpartum hemorrhage.
- Minimally invasive approaches can achieve hemostasis in complex PPH cases.
- These techniques may reduce the need for exploratory laparotomy in severe PPH.
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