scholarly journals Transvaginal ligation of descending branch of uterine artery: could be the first surgical attempt to control post-partum haemorrhage?

2021 ◽  
Vol 10 (5) ◽  
pp. 2042
Author(s):  
Marco Mitidieri ◽  
Elisa Picardo ◽  
Pierluigi Tondo ◽  
Chiara Benedetto ◽  
Saverio Danese
Keyword(s):  
Uterine Artery ◽  
Post Partum ◽  
The Body ◽  
Lower Segment ◽  
Severe Condition ◽  
Feeding Vessels ◽  
Post Partum Haemorrhage ◽  
Control Post ◽  
Lower Segment Uterine ◽  
Physical Morbidity

Post-partum haemorrhage is the major cause of maternal death worldwide. This severe clinical condition can cause also physical morbidity and psychological distress (anemia, coagulopathy, blood transfusion, anterior pituitary ischemia with delay or failure of lactation, myocardial ischemia, postpartum depression). To date several efforts have been made to prevent and treat this severe condition mainly in three ways: medical, surgical, and interventional radiology even in combination. The surgical approach, needs the knowledge of anatomy of vascular distribution of the uterus. According to Palacios-Jaraquemada the feeding vessels of the body of the uterus is defined S1 area and the lower segment, uterine cervix and upper part of the vagina, S2 area. We report three cases in which the ligation of the descending branch of uterine artery (S2 area) helped the surgeon in the treatment of severe primary post-partum haemorrhage causing a significant reduction in blood loss.

Foetal growth restriction in the next pregnancy after uterine artery embolisation for post-partum haemorrhage

2002 ◽  
Vol 103 (2) ◽  
pp. 183-184 ◽  
Author(s):  
Carine Cordonnier ◽  
Duc-Edouard Ha-Vien ◽  
Sandrine Depret ◽  
Véronique Houfflin-Debarge ◽  
Nathalie Provost ◽  
...  
Keyword(s):  
Uterine Artery ◽  
Post Partum ◽  
Growth Restriction ◽  
Uterine Artery Embolisation ◽  
Foetal Growth ◽  
Foetal Growth Restriction ◽  
Post Partum Haemorrhage

scholarly journals Vaginal ligation of descending branch of uterine artery in the management of massive secondary post-partum haemorrhage

2019 ◽  
Vol 8 (7) ◽  
pp. 2937
Author(s):  
Rudrika Chandra ◽  
Sanjay Singh
Keyword(s):  
Uterine Artery ◽  
Ultrasound Examination ◽  
Post Partum ◽  
Uterine Cavity ◽  
Placental Tissue ◽  
Haemorrhagic Shock ◽  
Sudden Onset ◽  
Bleeding Vessel ◽  
Vascular Ligation ◽  
Post Partum Haemorrhage

A 25 year old lady presented on day 22 of an uneventful caesarean delivery, in a state of class IV haemorrhagic shock, secondary to sudden onset of vaginal bleeding without any inciting cause. Immediate resuscitation was initiated and the cause for massive secondary post-partum haemorrhage (PPH) was identified as an actively bleeding vessel at 3 ‘O’ clock position on a visibly healthy cervix with a well contracted uterus. This was the descending branch of left uterine artery, which was ligated after pulling the cervix with a sponge holder towards the introitus and application of Vicryl No 1-0 suture. The bleeding decreased significantly post vascular ligation. Further exploration of vagina and cervix did not reveal any active bleeding or laceration and no retained placental tissue was found inside uterine cavity on ultrasound examination. This is a rare case of Massive Secondary PPH in a post-caesarean patient due to spontaneous giving way of descending branch of uterine artery.

Empowering women to control post-partum haemorrhage

The Lancet ◽  
2010 ◽  
Vol 375 (9713) ◽  
pp. 459-460 ◽  
Author(s):  
Malcolm Potts ◽  
Ndola Prata ◽  
Hazem El Refaey ◽  
Harsah Sanghvi ◽  
Phil Darney ◽  
...  
Keyword(s):  
Post Partum ◽  
Post Partum Haemorrhage ◽  
Control Post

scholarly journals Gynecological, reproductive and sexual outcomes after uterine artery embolization for post-partum haemorrage

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Béatrice Eggel ◽  
Maude Bernasconi ◽  
Thibaud Quibel ◽  
Antje Horsch ◽  
Yvan Vial ◽  
...  
Keyword(s):  
Success Rate ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Subsequent Pregnancy ◽  
Control Group ◽  
Artery Embolization ◽  
Interval Time ◽  
Sexual Outcomes

AbstractIn this case control study, long-term gynecological, reproductive and sexual outcomes after uterine artery embolization (UAE) for postpartum hemorrhage (PPH) were evaluated. The study was performed in a single referral hospital for PPH in Lausanne from 2003 to 2013. Each woman whose delivery was complicated by PPH and treated by UAE was included, and compared to a control group of women whose delivery was uncomplicated. Cases were matched by maternal age, parity, ethnicity, year and mode of delivery, birth weight and gestational age in a 1–3 ratio. A total of 77 patients treated by UAE for PPH were identified in our obstetrical database. Among them, 63 were included and compared to 189 matched patients (no PPH). The mean interval time between UAE and this study was 8.1 years. Time to menstrual cycle recovery after delivery (3.9 vs 5.6 months, p = 0.66), spotting (7.9% vs 7.2%, p = 0.49), dysmenorrhea (25.4% vs 22.2%, p = 0.60) and amenorrhea (14.3% vs 12.2%, p = 0.66) were similar between the two groups. There was no difference in the FSFI score between the groups (23.2 ± 0.6 vs 23.8 ± 0.4; p = 0.41). However, the interval time to subsequent pregnancy was longer for patients after UAE than the control group (35 vs 18 months, p = 0.002). In case of pregnancy desire, the success rate was lower after UAE compared to controls (55% vs 93.5%, p < 0.001). The rate of PPH was higher in those with previous PPH (6.6% vs 36.4%, p = 0.010). Patients treated by UAE for PPH did not report higher rates of gynecological symptoms or sexual dysfunction compared to patients with uneventful deliveries. The inter-pregnancy interval was increased and the success rate was reduced. In subsequent pregnancies, a higher rate of PPH was observed in those that underwent UAE.

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