Maternal, Fetal and Neonatal Medicine

Objective: To determine the most effective surgical method in postpartum hemorrhagic cases, this is a preventable and threatening mother’s life.

 

Method: This study was retrospectively reviewed from file archives and electronic file environment of Necmettin Erbakan University, Meram Medical Faculty Hospital, Gynecology and Obstetrics Clinic and patients who underwent a surgical procedure due to Postpartum Hemorrhage (PPH) between January 2010 and December 2014.

 

Results: Between January 2010 and December 2014, total 19535 deliveries were performed in our hospital. 48.6% of the deliveries were by cesarean and 52.4% by Normal Spontaneous Vaginal (NSD) route. 320 of these patients required surgical intervention in 240 of them. The most frequent etiologic cause for surgical intervention was found to be the uterine atony and placenta previa. The most effective surgical technique we used in this period in PPH patients was Acar technique (87.4%). The incidence of peripartum hysterectomy was 0.21/1000 in this period and one mother lost her life due to pulmonary embolism after hysterectomy.

 

Conclusion: As a result of this study, we found that acar technique was the most effective, fast and easy to administer in PPH management, with the least post-operative complication rate, requiring minimal blood and blood product replacement, minimum inpatient hospital stay. The clinician needs to be ready for PPK management at all times as surgical technique, experience and equipment, while increasing factors such as increased cesarean ratios, increased placental adhesion anomalies, increased maternal age, increased treatment pregnancies and multiple pregnancies are increasing day by day. They must follow new developments in this regard closely, be encouraged to apply new techniques, perform fast, effective and least invasive applications so as not to put the patient's life in danger.