The surgical management of post-partum haemorrhage

Onnig Tamizian, S. Arulkumaran

Research output: Contribution to journalReview article

35 Citations (Scopus)

Abstract

Life-threatening post-partum haemorrhage (PPH) occurs with a frequency of 1 per 1000 deliveries in the developed world. In the 1994-1996 Triennial Confidential Enquiry into Maternal Deaths in the United Kingdom primary PPH was responsible for five deaths. In this chapter we discuss briefly the assessment and initial medical management of the patient with primary PPH but concentrate on the surgical management where medical treatment has failed. The surgical management discussed includes both traditional or long-established management strategies together with newer, less radical surgical options, such as embolization techniques, uterine compression sutures and methods involving uterine tamponade, which are less hazardous to perform and have the advantage of preserving reproductive function. The recommendations of the reports from the Confidential Enquiries into Maternal Deaths in the UK are summarized at the end of the chapter.

Original languageEnglish
Pages (from-to)81-98
Number of pages18
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Volume16
Issue number1
DOIs
Publication statusPublished - Feb 2002

Keywords

  • Post-partum haemorrhage (PPH)
  • Stepwise devascularization of the uterus
  • Uterine 'compression' sutures
  • Uterine tamponade

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