Transvaginally surgically treatment of early postpartum hemorrhage caused by lower uterine segment atony

Dubravko Habek; Ingrid Marton; Matija Prka; Ana Tikvica Luetić; Mirjam Vitić; Ana Marija Jurković

doi:10.1515/jpm-2021-0686

Article

Transvaginally surgically treatment of early postpartum hemorrhage caused by lower uterine segment atony

Dubravko Habek , Ingrid Marton , Matija Prka , Ana Tikvica Luetić , Mirjam Vitić and Ana Marija Jurković

Published/Copyright: May 9, 2022

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From the journal Journal of Perinatal Medicine Volume 50 Issue 7

Abstract

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.

Keywords: lower uterine segment; management; postpartum hemorrhage; uterine atony

Corresponding author: Prof. Dubravko Habek, MD, MSc, PhD, PhD, University Department of Obstetrics and Gynecology Clinical Hospital “Sveti Duh”, School of Medicine Catholic University of Croatia, Ilica 242, 10000, Zagreb, Croatia, Phone: 00385 1 3712 187, Fax: 00385 1 3745 534, E-mail: dhabek@unicath.hr

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: Research was approved by Ethical Committee of our Hospital.

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Received: 2021-12-26

Accepted: 2022-03-27

Published Online: 2022-05-09

Published in Print: 2022-09-27

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Articles in the same Issue

https://doi.org/10.1515/jpm-2021-0686

Keywords for this article

lower uterine segment; management; postpartum hemorrhage; uterine atony