Approach to cases with postpartum haemorrhage: Retrospective analysis of 41 cases

• Main Authors: Adnan İncebıyık, Aysun Camuzcuoğlu, Neşe Gül Hilali, Ahmet Küçük, Hasan Hüsnü Yüce, Harun Aydoğan, Hakan amuzcuoğlu, Mehmet Vural
• Format: Article
• Language: English
• Published: Modestum Publishing LTD 2014-03-01
• Series: Journal of Clinical and Experimental Investigations
• Subjects: Surgical treatment; medical treatment
• Online Access: http://www.jceionline.org/upload/sayi/20/JCEI-00850.pdf

Objective: To assess treatment approaches and outcomes in 41 cases with postpartum haemorrhage (PPH). Methods: Screening the electronic database of the hospital identified 41 cases admitted to the obstetrics clinic with a diagnosis of PPH (ICD codes: O72, O72, O72.2) between January 1, 2010, and June 30, 2013. The clinical findings and the results of the surgical and medical treatments used were noted in all the patients. Results: Forty-one cases with PPH were detected who had been managed at the clinic during a 3-year period. Normal spontaneous vaginal delivery (26 patients; 63.4%) was the most common type of delivery. Uterine atony was the most common cause of PPH in 30 patients (73.2%). Medical therapy was the most common therapeutic approach in PPH caused by uterine atony (16 patients; 53.3%), followed by total abdominal hysterectomy (TAH) plus bilateral hypogastric artery ligation (9 patients; 30.0%), uterine packing sutures plus bilateral hypogastric artery ligation (BHAL) (4 patients; 13.3%) and intrauterine balloon tamponade (IUBT) (one patient; 2.4%). Only one of 3 patients with uterine rupture underwent a hysterectomy. Three patients in whom placental adhesion anomalies were detected were treated by a combination of manual removal of the placenta, uterine curettage and IUBT. Conclusion: The results suggest that care should be taken regarding PPH in pregnant women, even in those without any risk factors. In particular, the third phase of labour should be carefully monitored. Medical treatment and organ-sparing surgery are generally associated with positive outcomes in patients with stable haemodynamic status. J Clin Exp Invest 2014; 5 (1): 18-23