Transvaginally surgically treatment of early postpartum hemorrhage caused by lower uterine segment atony

Abstract

Abstract Objectives Prove the success of transvaginal hemostatic procedures in treatment of the early postpartum hemorrhage caused by lower uterine segment atony. Methods We have conducted a retrospective, clinical study during a 10-year period (2010–2019) in our institution that is tertiary perinatal university center. Results This particular study enrolled total number of 29,543 deliveries with 215 cases of early postpartum hemorrhage (0.72%). Lower uterine segment atony was diagnosed in 44 cases (29.93%) in all uterine atony cases of early postpartum hemorrhage. Hemostatic ligation procedures according to authors: Losickaja in two cases, Hebisch–Huch in 13 cases, Habek in seven cases, Hebisch-Huch + Losickaja in 10 cases. According to our results, hemostatic ligation procedures alone (32 cases; 72.72%) or combined with gauze or ballon tamponade (five cases, 11.36%), have shown to be highly effective in 37 cases (84.09%). Conclusions Lower uterine segment atony should definitely be identified and understood as a clinical entity. Transvaginal hemostatic approach for surgical treatment of lower uterine segment atony is accessible, minimally invasive, feasible, successful and lifesaving. All of the above-mentioned methods are of great importance in the prevention and treatment of obstetric shock, multiorgan failure, postpartum hysterectomy and finally vital for fertility preservation.