scholarly journals Effectiveness of Utero-Vaginal Packing in Management of Postpartum Hemorrhage

2017 ◽  
Vol 23 (1) ◽  
Author(s):  
Lubna Javed ◽  
Shamila Ijaz Munir ◽  
Amna Zia Eusaph
Keyword(s):  
Postpartum Hemorrhage ◽  
Genital Tract ◽  
Placenta Previa ◽  
Angiographic Embolization ◽  
Management Options ◽  
Effective Measure ◽  
Iliac Arteries ◽  
Mortality And Morbidity ◽  
Lower Segment Caesarean Section ◽  
Internal Iliac

<p>A major cause of maternal mortality and morbidity in developing world is postpartum hemorrhage (PPH). Different management options have been in use including use of oxytocins, prostaglandins, surgical exploration of genital tract, ligation or angiographic embolization of uterine/internal iliac arteries and hysterectomy. A simple and effective measure is to control bleeding with uterovaginal packing which is easy and quick to perform and saves the patient need of major surgical procedures.</p><p><strong>Objective:</strong><strong>  </strong>To determine effectiveness of uterovaginal packing in control of postpartum hemorrhage, its safety and complications associated with it.</p><p><strong>Place and Duration of Study:</strong><strong>  </strong>This study was carried out in Gynae unit 1 of Lady Willingdon Hospital Lahore from January 2014 – June 2015.</p><p><strong>Patients and Methods:</strong><strong>  </strong>It was a prospective interventional study. The patients presenting with postpartum hemorrhage after vaginal or abdominal delivery who did not respond to medical management were included in the study. Patients who had PPH due to genital tract trauma were excluded from this study. Frequencies and proportions of complications were calculated along with rate of successful cessation of bleeding. Data was analyzed by SPSS version 11.</p><p><strong>Results:</strong><strong>  </strong>99 patients who presented with PPH were included in study.49.5% were between age of 31 – 40 years, 38.4% were between 21– 30 years. 8.1% of patients were P1-2, 52.5% were P3-5 and 39.4% were P6 and above. 76.7% had hemorrhage after vaginal delivery and 23.3% after lower segment caesarean section. Uterineatony was the most common cause of postpartum hemorrhage, seen in 78.78% of cases, 9.09% had placenta previa, 8.08% presented with abruption placenta and 4.04% had coagulopathy. Regarding complications 7 women had to undergo hysterectomy, fever occurred in 14.14%, 8.08% had wound infection and 2 patients died of Disseminated Intravascular Coagulation (DIC). Procedure was successful in 90.9% of cases.</p><p><strong>Conclusion:  </strong>Utero-vaginal packing effectively controls postpartum hemorrhage with fewer complications and its role in emergency obstetric scan not be denied.</p>

scholarly journals Role of emergency bilateral internal iliac ligation in postpartum hemorrhage

2021 ◽  
Vol 10 (8) ◽  
pp. 3086
Author(s):  
Sunder Pal Singh ◽  
Shipra Misra ◽  
Naresh Sharma
Keyword(s):  
Retrospective Study ◽  
Iliac Artery ◽  
Postpartum Hemorrhage ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Uterine Perforation ◽  
Life Saving ◽  
Internal Iliac ◽  
Early Decision

ABSTRACTBackground: The aim of the study was to determine the effectiveness of emergency bilateral internal iliac ligation in intractable postpartum hemorrhage.Methods: A retrospective study was done on 33 women who have undergone emergency bilateral internal iliac ligation in obstetrics haemorrhage.Results: In all of 33 women under this study bilateral internal iliac ligation was performed in emergency. (11) of the cases were of atonic PPH, placenta previa (8), uterine rapture (7), extension of C-section scar (3), vaginal and cervical laceration (3) and uterine perforation (1). hysterectomy was not performed in any of the cases. internal iliac artery was injured in one case during the procedure and was managed successfully but two patients died during and after the BIIL.Conclusions: BIIL is an effective, less time consuming and life-saving procedure in intractable obstetrics hemorrhage if early decision is taken and performed by practiced surgeons.

scholarly journals Placenta Previa with Succenturiate Placenta–Delivered with a Living Healthy Baby

2016 ◽  
Vol 30 (2) ◽  
pp. 116-118
Author(s):  
Sangita Patra ◽  
Pallab Kumar Mistry ◽  
Mrinmoyee Dutta ◽  
Indrani Das
Keyword(s):  
Postpartum Haemorrhage ◽  
Placenta Previa ◽  
Healthy Male ◽  
Healthy Baby ◽  
Iliac Arteries ◽  
Antepartum Haemorrhage ◽  
Male Baby ◽  
Vasa Previa ◽  
Internal Iliac ◽  
Internal Iliac Arteries

The placenta is a flattened discoidal mass . Placenta with various abnormal shape like bidiscoidal, low-patiented, placenta membranacae or diffuse, placenta succenturiata, circumvallate circummarginate placentae have been less encountered but very remotely studied in relevance to clinical significance. Placenta succenturiata is a bilobbed placenta , where there is one large and one small part, connected with membranous vessels. It is associated with antepartum haemorrhage, Vasa previa, postpartum haemorrhage, retained lobe of placentae and infection. Antepartum haemorhage due to placenta succenturiata appears to be uncommonly recorded in the literature. We describe a case of placenta succenturiata , presented with antepartum haemorrhage. By LSCS a living healthy male baby of 3.3 kgs was delivered. Ultimately the Internal Iliac arteries were ligated to stop lower uterine segment bleeding.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 116-118

scholarly journals Emergency obstretic hysterectomy: a retrospective study in a tertiary care center

2019 ◽  
Vol 8 (6) ◽  
pp. 2368
Author(s):  
Vaishnavi Sanjay Shivade ◽  
Vaishali S. Vhawal ◽  
Manisha M. Laddad
Keyword(s):  
Maternal Mortality ◽  
Postpartum Hemorrhage ◽  
Early Stage ◽  
Placenta Previa ◽  
Care Center ◽  
Tertiary Care ◽  
Successful Operation ◽  
Management Options ◽  
Primary Indication ◽  
Skilled Operator

Background: Obstetric hysterectomy remains a necessity in preventing maternal mortality in catastrophic rupture of the uterus or intractable postpartum hemorrhage when all the conservative management options fail. Uterine atony followed by abnormal placentation remains the primary indication of emergency obstratic hysterectomy worldwide. In majority of cases, anticipation, prompt resuscitation and earlier surgical intervention by skilled operator will reduce patient’s morbidity and mortality. The first successful operation was performed in 1876. The main objective of the study was to study frequency, indications and fetomaternal outcome of emergency obstetric hysterectomy in tertiary care center.Methods: Observational, retrospective and analytical study was done over 2 years from January 2017 to January 2019. A total of 11 cases of emergency obstretic hysterectomy (EOH) were recorded.Results: The overall incidence was 1.47 per 1000 deliveries. Atonic postpartum hemorrhage (54%) was the most common indication followed by placenta previa (18%) and placenta accreta (9%). Second gravida were mostly involved (45%) with previous LSCS (45%) as a common risk factor in commonest age group of 20-25 years (46%) amongst them. The most frequent squeal was disseminated intravascular coagulation (45%). Maternal mortality was nil while neonatal mortality being 9%. The decision of performing total or subtotal hysterectomy along with bilateral internal iliac ligation was influenced by patient’s condition.Conclusions: Emergency obstretic hysterectomy is the most demanding obstretic surgery performed in circumstances of life threatening hemorrhages where conservative surgical modalities fail and interventional radiology is not immediately available. Antenatal anticipation of the risk factors, involvement of experienced obstetrician at the early stage of management and prompt hystrectomy after adequate rescuitation will reduce fetomaternal mortality and morbidity.

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