Surgical management of postpartum hemorrhage

Semin Perinatol. 2019 Feb;43(1):27-34. doi: 10.1053/j.semperi.2018.11.006. Epub 2018 Nov 14.

Abstract

When medical management of PPH is unsuccessful, surgical options should be utilized in a timely fashion in order to reduce maternal morbidity and mortality. This chapter describes ways of effective preparation, mobilization of resources and an organized approach to evaluation and surgical amelioration of PPH. Multiple fertility preserving surgical techniques to control PPH are described. Although a variety of conservative surgical approaches can be used in the setting of PPH, in a hemodynamically unstable patient, readiness for definitive management with a hysterectomy is necessary in order to reduce the risk of maternal mortality.

Keywords: Hemorrhage; Surgical; hysterectomy; laceration; postpartum; repair.

Publication types

  • Review

MeSH terms

  • Female
  • Fertility Preservation / methods*
  • Guidelines as Topic
  • Humans
  • Hysterectomy / methods*
  • Organ Sparing Treatments
  • Patient Selection
  • Postpartum Hemorrhage / surgery*
  • Pregnancy
  • Uterine Artery Embolization / methods*
  • Uterus / surgery*