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Obstetric Management of Postpartum Haemorrhage

  • Millicent Nwandison
  • Susan Bewley
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Obstetric haemorrhage remains the leading cause of maternal mortality and morbidity worldwide, but deaths are rare in developed countries. The use of interventional radiology over the last 30 years has changed from a novel technique in specialised centres to become a viable management option in the control of massive haemorrhage both before and after hysterectomy. This chapter covers the management of postpartum haemorrhage and the role of interventional radiology.

Keywords

Maternal Death Uterine Artery Uterine Artery Embolisation Postpartum Haemorrhage Uterine Atony 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Begley CM, Gyte GML, Devane D, McGuire W, Weeks A (2011) Active versus expectant management for women in the third stage of labour (Review). Cochrane Database Syst Rev 11Google Scholar
  2. Bhal K, Bhal N, Mulik V, Shankar L (2005) The uterine compression suture—a valuable approach to control major haemorrhage at lower segment caesarean section. J Obstet Gynaecol 25:10–14PubMedCrossRefGoogle Scholar
  3. B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ (1997) The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. BJOG 104(3):372–375CrossRefGoogle Scholar
  4. Centre for Maternal and Child Enquiries (CMACE) (2011) Saving mothers’ lives: reviewing maternal deaths to make motherhood safer: 2006–08. The eighth report on confidential enquiries into maternal deaths in the United Kingdom. BJOG 118(Suppl 1):1–203Google Scholar
  5. Cho JH, Jun HS, Lee CN (2000) Haemostatic suturing technique for uterine bleeding during caesarean delivery. Obstet Gynecol 96:129–131PubMedCrossRefGoogle Scholar
  6. Doumouchtsis SK, Papageorghiou AT, Arulkumaran S (2007) Systematic review of conservative management of postpartum haemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv 62:540–547PubMedCrossRefGoogle Scholar
  7. Fotopoulou C, Dudenhausen JWW (2010) Uterine compression sutures for preserving fertility in severe postpartum haemorrhage: an overview 13 years after the first description. J Obstet Gynecol 30(4):339–349CrossRefGoogle Scholar
  8. Hayman RG, Arulkumaran S, Steer PJ (2002) Uterine compression sutures: surgical management of postpartum haemorrhage. Obstet Gynecol 99:502–506PubMedCrossRefGoogle Scholar
  9. Healthcare Commission (2006) Investigation into 10 maternal deaths at, or following delivery at, Northwick Park Hospital, North West London Hospitals NHS Trust, between April 2002 and April 2005. Commission for Healthcare Audit and Inspection, London. http://webarchive.nationalarchives.gov.uk/20080609174704, http://www.healthcarecommission.org.uk/_db/_documents/Northwick_tagged.pdf
  10. Josephs SC (2008) Obstetric and gynaecologic emergencies: a review of indication and interventional techniques. Semin Intervent Radiol 25:337–346PubMedCentralPubMedCrossRefGoogle Scholar
  11. Joshi VM, Otiv SR, Majumder R, Nikam YA, Shrivastava M (2007) Internal iliac artery ligation for arresting postpartum haemorrhage. BJOG 114(3):356–361PubMedCrossRefGoogle Scholar
  12. Kayem G, Kurinczuk JJ, Alfirevic Z, Spark P, Brocklehurst P, Knight M (2011) Specific second-line therapies for postpartum haemorrhage: a national cohort study. BJOG 118(7):856–864PubMedCrossRefGoogle Scholar
  13. Knight M (on behalf of UKOSS) (2007) Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage. BJOG 114:1380–1387Google Scholar
  14. Lee JS, Shepherd SM (2010) Endovascular treatment of postpartum haemorrhage. Clinical Obstet Gynecol 53(1):209–218CrossRefGoogle Scholar
  15. Maassen MS, Lambers MD, Tutein Nolthenius RP, van der Valk PH, Elgersma OE (2009) Complications and failure of uterine artery embolization for intractable postpartum bleeding. BJOG 116(1):55–61PubMedCrossRefGoogle Scholar
  16. Mallappa Saaroja CS, Nankani A, El-Hamamy E (2010) Uterine compression sutures, an update: review of efficacy safety and complication of B-lynch suture and other uterine compression techniques for postpartum haemorrhage. Arch Gynecol Obstet 281(4):581–588CrossRefGoogle Scholar
  17. Mousa HA, Alfirevic Z (2007) Treatment for primary postpartum haemorrhage. Cochrane Database Syst RevGoogle Scholar
  18. Nelson GS, Birch C (2006) Compression sutures for uterine atony and haemorrhage following caesarean delivery. Int J Gynaecol Obstet 92:248–250PubMedCrossRefGoogle Scholar
  19. Nikolic B, Spies JB, Lundsten MJ, Abbara S (2000) Patient radiation dose associated with uterine artery embolization. Radiology 214:121–125PubMedCrossRefGoogle Scholar
  20. Nizard J, Barrinque L, Frydman R, Fernandez H (2003) Fertility and pregnancy outcomes following hypogastric artery ligation for severe post-partum haemorrhage. Hum Reprod 18:844–848PubMedCrossRefGoogle Scholar
  21. Ouahba J, Piketty M, Huel C, Azarian M, Feraud O, Luton D, Sibony O, Oury JF (2007) Uterine compression sutures for postpartum bleeding with uterine atony. BJOG 114(5):619–622PubMedCrossRefGoogle Scholar
  22. Palacios-Jaraquemada JM (2011) Efficacy of surgical techniques to control obstetric haemorrhage: analysis of 539 cases. Acta Obstet Gynecol Scand 90(9):1036–1042PubMedCrossRefGoogle Scholar
  23. Pelage JP, Le Dref O, Jacob D (1999) Selective embolization in the management of intractable postpartum bleeding. Acta Obstet Gynecol Scand 78(8):698–703PubMedCrossRefGoogle Scholar
  24. Pereira A, Nunes F, Pedroso S, Saraiva J, Retto H, Meirinho M (2005) Compressive uterine sutures to treat postpartum bleeding secondary to uterine atony. Obstet Gynecol 106:569–572PubMedCrossRefGoogle Scholar
  25. Royal College of Obstetricians and Gynaecologists (2007) The role of emergency and elective interventional radiology in postpartum haemorrhage. Royal College of Obstetricians and Gynaecologists Good Practice Guideline No 6. Royal College of Obstetricians and Gynaecologists, London. http://www.rcog.org.uk/womens-health/clinical-guidance/role-emergency-and-electiveinterventional-radiology-postpartum-haem
  26. Royal College of Obstetricians and Gynaecologists (2009) Green top guideline No 52. Prevention and management of postpartum haemorrhage (revised November 2009 and April 2011). http://www.rcog.org.uk/womens-health/clinical-guidance/prevention-and-management-postpartum-haemorrhage-green-top-52
  27. Shim JY, Yoon HK, Won HS, Kim SU, Lee PI, Kim A (2006) Angiographic embolization for obstetric haemorrhage; effectiveness and follow-up outcomes. Acta Obstet Gynecol Scand 85(7):815–820PubMedCrossRefGoogle Scholar
  28. Sukhbir S, Boardman R, Leyland N (2007) Pregnancy after uterine artery embolization. Can Fam Physician 53(2):293–295Google Scholar
  29. Vegas G, Illescas T, Muñoz M, Perez-Pinar A (2006) Selective pelvic arterial embolization in the management of obstetric haemorrhage. Eur J Obstet Gynaecol Reprod Biol 127(1):68–72CrossRefGoogle Scholar
  30. WHO, UNICEF, UNFPA and The World Bank publication (2012) Trends in Maternal Mortality 1990-2008. http://whqlibdoc.who.int/publications/2010/9789241500265_eng.pdf and http://www.childinfo.org/maternal_mortality.html

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Speciality Registrar in Obstetrics and GynaecologyLondon DeaneryLondonUK
  2. 2.Academic Women’s Health CentreKing’s College LondonLondonUK

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