Current practice of ultrasound in the management of postpartum hemorrhage: a secondary analysis of a national survey

Ilenia Mappa; Bianca Masturzo; Tullio Ghi; Giuseppe Rizzo; on behalf of the working group of ultrasound in labor of the Italian Society of Ultrasound in Obstetrics and Gynecology

doi:10.1515/jpm-2024-0231

Article

Current practice of ultrasound in the management of postpartum hemorrhage: a secondary analysis of a national survey

Ilenia Mappa , Bianca Masturzo , Tullio Ghi , Giuseppe Rizzo and on behalf of the working group of ultrasound in labor of the Italian Society of Ultrasound in Obstetrics and Gynecology

Published/Copyright: August 1, 2024

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From the journal Journal of Perinatal Medicine Volume 52 Issue 8

Abstract

Objectives

Although frequently employed in the delivery room, current guidelines do not recommend the use of ultrasound in the setting of postpartum hemorrhage (PPH). The aim of this survey was to evaluate the routine use of ultrasonography during PPH.

Methods

A questionnaire, composed by a series of questions that assess participant characteristics and ultrasound use during PPH, was sent to members of the Italian Society of Ultrasound in Obstetrics and Gynecology currently employed in obstetrical units. Answers were subsequently grouped based on participant characteristics.

Results

Based on the responses of 200 participants it was found that ultrasound was routinely employed by 67 % of participants during PPH, by 85 % if Retained Products of Conception (RPOC) was suspected, by 67 % during Bakri balloon placement and by 69 % during curettage procedures. Routine ultrasound use was higher amongst participants working in hospitals with a higher number of deliveries, by those with more years of experience using ultrasound in labor, and by those that had attended specific postgraduate training courses.

Conclusions

Despite the lack of recommendations in the current guidelines, the results of this survey show that ultrasound seems to be commonly employed by maternal fetal medicine practitioners in the management of PPH.

Keywords: postpartum hemorrhage; ultrasound; labor; retained product of conception; uterine tamponade

Corresponding author: Ilenia Mappa, MD, Department of Obstetrics and Gynecology, Fondazione Policlinico Tor Vergata, Università di Roma Tor Vergata, Viale Oxford 81, 00133 Roma, Italy, E-mail: mappa.ile@gmail.com

Research ethics: As the study did not involve direct patient involvement, an approval from the Ethical Committee was not deemed necessary according to Italian regulation.
Informed consent: Not applicable.
Author contributions: All Authors provided a substantial contribution to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting the work or revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Competing interest: The authors state no conflict of interest.
Research funding: None declared.
Data availability: Data available from authors on reasonable request.

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Received: 2024-05-18

Accepted: 2024-07-07

Published Online: 2024-08-01

Published in Print: 2024-10-28

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Articles in the same Issue

https://doi.org/10.1515/jpm-2024-0231

Keywords for this article

postpartum hemorrhage; ultrasound; labor; retained product of conception; uterine tamponade