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Transvaginally surgically treatment of early postpartum hemorrhage caused by lower uterine segment atony
Dubravko Habek1, Ingrid Marton1, Matija Prka1
1University Department of Obstetrics and Gynecology Clinical Hospital "Sveti Duh", School of Medicine Catholic University of Croatia, Zagreb, Croatia.
Objectives:
Prove the success of transvaginal hemostatic procedures in treatment of the early postpartum hemorrhage caused by lower uterine segment atony.
Methods:
We have conducted a retrospective, clinical study during a 10-year period (2010-2019) in our institution that is tertiary perinatal university center.
Results:
This particular study enrolled total number of 29,543 deliveries with 215 cases of early postpartum hemorrhage (0.72%). Lower uterine segment atony was diagnosed in 44 cases (29.93%) in all uterine atony cases of early postpartum hemorrhage. Hemostatic ligation procedures according to authors: Losickaja in two cases, Hebisch-Huch in 13 cases, Habek in seven cases, Hebisch-Huch + Losickaja in 10 cases. According to our results, hemostatic ligation procedures alone (32 cases; 72.72%) or combined with gauze or ballon tamponade (five cases, 11.36%), have shown to be highly effective in 37 cases (84.09%).
Conclusions:
Lower uterine segment atony should definitely be identified and understood as a clinical entity. 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.
