A local hemostatic agent for the management of postpartum hemorrhage due to placenta previa and placenta accreta: a cross-sectional study

作者：Portilla Diego; Hernandez Giraldo Cristian^*; Moreno Bernardo; Quijano Fabio; Hoyos Luis R; Angarita Ana Milena; Madero Santiago

来源：Archives of Gynecology and Obstetrics, 2013, 288(3): 543-549.

DOI：10.1007/s00404-013-2812-1

• Postpartum Hemorrhage
• Cellulose, Oxidized
• Hysterectomy
• Placenta previa
• Placenta accreta

To describe the use of a local hemostatic agent (LHA) for the management of postpartum hemorrhage (PPH) due to bleeding of the placental bed in patients taken to caesarean section at Fundacin Santa Fe de Bogota University Hospital.
A total of 41 pregnant women who had a caesarean section and developed PPH.
A cross-sectional study. Analysis of all cases of PPH during caesarean section presented from 2006 up to and including 2012 at Fundacin Santa Fe de Bogota University Hospital.
Emergency hysterectomy due to PPH.
The proportion of hysterectomies was 5 vs. 66 % for the group that received and did not receive management with a LHA respectively (PR 0.07, CI 95 % 0.01-0.51 p < 0.01). For the group managed without a LHA, 80 % of patients needed hemoderivatives transfusion vs. 20 % of patients in the group managed with a LHA (PR 0.24, CI 95 % 0.1-0.6 p < 0.01). A reduction in the mean days of hospitalization in addition to a descent in the proportion of patients admitted to the intensive care unit (ICU) was noticed when comparing the group that received a LHA versus the one that did not.
An inverse association between the use of a LHA in patients with PPH due to bleeding of the placental bed and the need to perform an emergency obstetric hysterectomy was observed. Additionally there was a significant reduction in the mean duration of hospital stay, use of hemoderivatives and admission to the ICU.

• 出版日期2013-9