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Postpartum Hemorrhage: Mechanical and Surgical Treatment

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Abstract

Postpartum hemorrhage is a growing medical problem associated with the clinically significant increase of postpartum hysterectomy rate. Currently physicians are making greater use of the uterine balloon tamponade method, a simple and efficacious approach towards managing bleeding in both vaginal and cesarean delivery.

This chapter presents an overview of the original Free Flow balloon tamponade method, the unique approach allowing for compression of hemorrhaging uterine vessels while preserving the restoration of uterine contractile function. In the majority of cases the complete cessation of bleeding is achieved within 30-40 min.

The joint application of autonomous uterine and vaginal catheters has made solving a dangerous inherent problem associated with the method, that of balloon expulsion, a possibility, along with significantly improving the success rate of lower segment uterine bleeding arrest with the addition of inter-balloon compression effect.

In cases of bleeding associated with vaginal lacerations the autonomous use of vaginal balloon provides adequate hemostasis when suturing is insufficient, while uniquely preserving the free outflow of lochia from the uterine cavity.

The application of double-balloon assembly system along with certain supplementary techniques, such as hemostatic external uterine supraplacental pleated sutures and bilateral ligation of the descending uterine artery branches, has been associated with a greater that fourfold drop in postpartum hysterectomy rates, simultaneously serving as a tool for early identification of patients in whom postpartum hysterectomy is indicated.

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Author information

Authors and Affiliations

  1. GynaMed Company, Moscow, Russia

    Yakov G. Zhukovskiy MD

  2. Moscow Regional Perinatal Center, Department of Obstetrics, Gynecology and Perinatology, Russian Federal Center of Biophysics, Moscow, Russia

    Olga F. Serova MD, PhD

  3. Department of Obstetrics and Gynecology, Omsk State Medical University, Omsk, Russia

    Sergey V. Barinov MD, PhD

Authors
  1. Yakov G. Zhukovskiy MD
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  2. Olga F. Serova MD, PhD
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  3. Sergey V. Barinov MD, PhD
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Corresponding author

Correspondence to Yakov G. Zhukovskiy MD .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Santa Maria Hospital, G.V.M. Care and Research, Bari, Italy

    Antonio Malvasi

  2. Department of Obstetrics and Gynecology, Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, Piazza Muratore, Lecce, Italy

    Andrea Tinelli

  3. Department of Obstetrics and Gynecology, Centre for Perinatal and Reproductive Medicine, Santa Maria della Misericordia University, Hospiatal, Perugia, Italy

    Gian Carlo Di Renzo

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Zhukovskiy, Y.G., Serova, O.F., Barinov, S.V. (2017). Postpartum Hemorrhage: Mechanical and Surgical Treatment. In: Malvasi, A., Tinelli, A., Di Renzo, G. (eds) Management and Therapy of Late Pregnancy Complications. Springer, Cham. https://doi.org/10.1007/978-3-319-48732-8_16

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  • DOI: https://doi.org/10.1007/978-3-319-48732-8_16

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-48732-8

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