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Tisseel for management of traumatic postpartum haemorrhage

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Abstract

Introduction

Following the introduction of haemostatic agents, new opportunities are available when facing problematic bleeding. We report the first case of traumatic postpartum hemorrhage successfully controlled with a fibrin sealant.

Case presentation

26-year nulliparous patient had a rotational forceps delivery and developed multiple vaginal lacerations. Haemostasis could not be achieved after suturing, vaginal packing and IV tranaxemic acid. She lost approx. 3,500 ml blood and received 4 U transfusion. Tisseel was used as a thin layer on vaginal wall and bleeding settled. She had good recovery and perineum healed well.

Conclusion

Tisseel consists of a two-component fibrin biomatrix to stop diffuse bleeding. When the tissues are very oedematous, it can be difficult to insert sutures. We tried this innovative option with very effective results. The absence of long-term complications is reassuring and we recommend its use in similarly extreme situations.

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Abbreviations

CEMACH:

Confidential enquiry into maternal and child health

UKOSS:

United Kingdom Obstetric Surveillance System

PPH:

Postpartum haemorrhage

APTT:

Activated partial thromboplastin time

PT:

Prothrombin time

References

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Conflict of interest statement

The author(s) declare that they have no competing interests.

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Authors and Affiliations

  1. The Jessop Wing, Tree Root Walk, Sheffield, S10 3SF, UK

    Jaya Saxena Dhulkotia, M. Alazzam & A. Galimberti

Authors
  1. Jaya Saxena Dhulkotia
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  2. M. Alazzam
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  3. A. Galimberti
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Corresponding author

Correspondence to Jaya Saxena Dhulkotia.

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Dhulkotia, J.S., Alazzam, M. & Galimberti, A. Tisseel for management of traumatic postpartum haemorrhage. Arch Gynecol Obstet 279, 437–439 (2009). https://doi.org/10.1007/s00404-008-0824-z

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  • DOI: https://doi.org/10.1007/s00404-008-0824-z

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