Some aspects of surgical hemostasis of massive postpartum hemorrhage

Abstract

Objective: to study the effectiveness of compression sutures in massive postpartum obstetric hemorrhages. Methods: The study involved 5370 pregnant women who delivered babies in the Akmola Regional Hospital No. 2 in 2015-2017. Clinical, laboratory and instrumental methods were used in the study. A retrospective analysis of cases of obstetric hemorrhages was carried out in 2006 - 2008, before the introduction of haemostatic sutures to the uterus in cases of Massive Obstetric Hemorrhage (MOH). Results: Before the introduction of haemostatic sutures to the uterus, in the cases of MOH, hysterectomy was mainly performed, with the expanded volume prevailing, i.e., the extirpation of the uterus, which was 6.1% of the total number of obstetric hemorrhages, and 35.7% from the MOH. During the last 3 years (2015-2017) in the maternity ward of Akmola Regional Hospital # 2, the frequency of obstetric hemorrhage decreased from 4.1% to 2.3% (1.8 times) compared to the period before the application of haemostatic sutures to the uterus. An attitude towards the removal of the uterus was changed qualitatively. With the introduction of the clinical protocol "Obstetric Bleeding" and the development of the technique of haemostatic sutures on the uterus, with obstetric hemorrhages in the maternity ward, hysterectomy was reduced by 2 times. Conclusions: timely and technically correctly applied haemostatic sutures to the uterus are effective methods that allow to save the organ and reproductive function of women who underwent massive obstetric hemorrhage.

Keywords

• cesarean section
• postpartum hemorrhage
• surgical hemostasis
• haemostatic sutures to the uterus
• hysterectomy