A New Surgical Way to Face Postpartum Hemorrhage - Open Journal of Obstetrics and Gynecology

OJOG > Vol.10 No.9, September 2020

Open Journal of Obstetrics and Gynecology

Volume 10, Issue 9 (September 2020)

ISSN Print: 2160-8792 ISSN Online: 2160-8806

Google-based Impact Factor: 0.37 Citations h5-index & Ranking

A New Surgical Way to Face Postpartum Hemorrhage ()

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DOI: 10.4236/ojog.2020.1090108 535 Downloads 2,257 Views Citations

Author(s)

Loutfi Guennoun Abdelmounaim^1*, N. Biougnach¹, Barka Rabea², Harbil Driss³, Tmiri Adil⁴, Lafkir Said⁵

Affiliation(s)

¹Department of Obstetrics and Gynecology, Maternal & Child Regional Center of Meknes, Mohammed V University, Rabat, Morocco.
²Department of Obstetrics and Gynecology, Higher Institute of Nursing and Health Techniques, Meknes, Morocco.
³Higher Institute of Nursing and Health Techniques, Rabat, Morocco.
⁴The Maternal & Child Regional Center of Meknes, Hassan II University, Casablanca, Morocco.
⁵The Inter-Communal Medical Center of Meknes, Hassan II University, Casablanca, Morocco.

ABSTRACT

Objective: We introduced two novel hemostatic techniques to achieve hemostasis for postpartum hemorrhage (PPH). The first one (A: Uterus Isthmic Plication) was a new uterine compression suture, which compresses the hysterotomy site. In a severe case, we further added vessel ligation suture after performing A-suture (B-combination suture: B-suture: A + Wide Lateral Uterine Vascular Ligation). Methods: Of 130 PPH cases, 90 were with mild PPH and 40 were with severe PPH. Our policy was: perform A-suture to mild PPH and perform B (combination) to severe PPH. Study was performed during 2018-2019. The primary endpoint to evaluate the efficacy of the procedures was preserving the uterus (no hysterectomy). Results: A-procedure, performed to 90 patients with mild PPH, was effective to all 90 patients, with all preserving the uterus. B-procedure, performed 38 patients with severe PPH (excluding two patients with uterine rupture), was effective in 37 patients, with one having undergone hysterectomy due to coagulopathy. Conclusion: Uterus Isthmic Plication (A-procedure) and addition of Wide Lateral Uterine Vascular Ligation to procedure-A (B-procedure) achieved hemostasis in patients with PPH. Prospective study is necessary to confirm the present data.

KEYWORDS

Postpartum: PPH, Hemorrhage, Surgical, Technique, Uterus, Plication, Vascular, Ligation, Hemostatic, Hematometry, Amenorrhea and Isthmocoele

Share and Cite:

Abdelmounaim, L. , Biougnach, N. , Rabea, B. , Driss, H. , Adil, T. and Said, L. (2020) A New Surgical Way to Face Postpartum Hemorrhage. Open Journal of Obstetrics and Gynecology, 10, 1147-1155. doi: 10.4236/ojog.2020.1090108.

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