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Massive Pontine Hemorrhage by Dual Injection of Autologous Blood
Published on: May 29, 2021
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Life-threatening postpartum hemorrhage (≥ 5000 mL): a single center experience
Xiao Yue Guo1,2,2, Yan Zhang3,4,4, Yang Yu Zhao1,2,2
1Department of Obstetrics and Gynecology, Peking University 3rd Hospital, Beijing, China, China.
Ginekologia Polska
|March 22, 2022
Summary
Life-threatening postpartum hemorrhage (PPH) is often caused by placenta accrete spectrum (PAS). Massive transfusion protocols (MTP) and multidisciplinary care are effective for managing severe PPH, ensuring good maternal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Hemorrhagic Disorders
Background:
- Life-threatening postpartum hemorrhage (PPH), defined as ≥ 5000 mL blood loss, poses significant risks to maternal health.
- Understanding the specific etiologies and effective management strategies for severe PPH is critical for improving patient outcomes.
Purpose of the Study:
- To investigate the causes, interventions, and outcomes of life-threatening PPH.
- To compare clinical characteristics and outcomes between patients with PPH due to placenta accrete spectrum (PAS) and uterine atony.
Main Methods:
- Retrospective analysis of clinical data from 42 patients with life-threatening PPH.
- Patients were categorized into either the placenta accrete spectrum (PAS) group (n=35) or the uterine atony group (n=7).
Main Results:
- The PAS group exhibited higher rates of gravidity, parity, cesarean sections, abortions, and intrauterine operations compared to the uterine atony group.
- Patients in the PAS group delivered at significantly earlier gestational ages and had lower newborn birth weights.
- Massive transfusion protocols (MTP) were utilized with a blood product ratio consistent with recommendations (1:1:1), and catheter placement duration was longer in the PAS group; however, no significant differences in complications or maternal outcomes were observed, with no maternal deaths.
Conclusions:
- Placenta accrete spectrum (PAS) is identified as a primary cause of life-threatening PPH.
- Effective management of severe PPH involves the implementation of MTP, supported by multidisciplinary collaboration, leading to favorable maternal prognoses.
