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Chapter-25 Postpartum Hemorrhage—Surgical Interventions

BOOK TITLE: Operative Obstetrics and Gynecology

Author
1. Desai Pankaj
2. Deshpande Hemant
ISBN
9788184485370
DOI
10.5005/jp/books/11088_25
Edition
1/e
Publishing Year
2009
Pages
12
Author Affiliations
1. Janani Maternity Hospital, Baroda, Medical College and SSG Hospital, Baroda, Gujarat, India, Medical College, SSG Hospital and Baroda, Gujarat, India, Janani Maternity Hospital, Vadodara, Gujarat, India; Medical College and SSG Hospital, Vadodara, Gujarat, India; Societies of India (FOGSI), 2007, Baroda Medical College and Sir Sayajirao General Hospital, Vadodara, Gujarat, India, Medical College, Vadodara, Gujarat, India, Baroda, Baroda, Gujarat, India, Medical Collage and SSG Hospital, Vadodara, Gujarat, India, Janani Maternity Hospital, Baroda, Gujarat, India, Medical College, Baroda, Gujarat, India, FOGSI; Janani Maternity Hospital, Baroda, India, Medical College, Baroda, Medical College and SSG Hospital Baroda, Medical College, Baroda, India, Medical College and SSG Hospital, Baroda, Gujarat, (Unit IV), Medical College and SSG Hospital, Baroda, Medical College and SSG Hospital, Vadodara, Gujarat, India, Medical College and SSG Hospital, Baroda, Dept of Obs and Gyn Medical College, Baroda, Medical College
2. DY Patil Medical College, Pune, Padmashree Dr DY Patil Medical College and Hospital, Pimpri, Pune, Maharashtra, Pune, Maharashtra, India, DY Patil Medical College, Pune, Maharashtra, India, Dr DY Patil Medical College and Hospital, Pune, Maharashtra, India, Pune, Dr D Y Patil Medical College and Hospital, Pune, Maharashtra, India, Dr DY Patil Medical College, Pune, Maharashtra, India, Dr DY Patil Medical College and Hospital, Dr DY Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India, Vice-Dean, DY Patil Medical College, Pune, Maharashtra, India
Chapter keywords
uterus, hypogastric artery, retroperitoneal space, ligation, fertility, surgical therapies, circulating volume, definitive treatment, ischemic phenomena, vaginal fornices, bleeding, tender swelling, oozing

Abstract

This chapter discussed some surgical interventions in case of postpartum hemorrhage. Management of postpartum hemorrhage can be done by fluid therapy, blood transfusion, and monitoring response to resuscitation. Surgical management includes intrauterine tamponade, intrauterine condom packing, and packing of the uterus. Pressure or packing over the repair may achieve homeostasis or allow for better placement of further hemostatic stitches. Selective arterial embolization is the treatment of choice if intervention is required in patients with broad ligament and retroperitoneal hematoma. The christopher B-lynch suturing technique is a right alternative to major surgical procedures to control pelvic arterial pulse pressure or hysterectomy. The vaginal route offers a novel, simple, effective, and minimally invasive technique for treating intractable puerperal hemorrhage by uterine artery ligation.

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