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How to quickly and effectively treat postpartum hemorrhage?

June 21,2023

So far, postpartum hemorrhage is the leading cause of maternal death in my country.

Compared with other critical diseases, postpartum hemorrhage is not only more harmful, but also has a high incidence rate, which is a very common clinical disease.

At present, the existing methods of postpartum hemostasis can be divided into drug hemostasis and physical hemostasis. Physical hemostasis refers to the method of hemostasis that does not rely on the action of drugs, including soft birth canal packing, postpartum forceps curettage, various pressure sutures and interventional embolization of uterine arteries.


1. Soft birth canal tamponade

Yarn stuffing: In the past, long yarn was used. This material is cheap, and the operation takes a lot of time, which is easy to delay the rescue time. And because it is difficult for the gauze to ensure sufficient contact with the entire intima, it may lead to failure of compression hemostasis.

Balloon stuffing:  The balloon overcomes the shortcomings of many yarns, such as smooth surface, can form a shape that fits the uterine cavity after water injection, exerts the effect of compressive hemostasis, and has a drainage channel, which can observe the bleeding in the uterine cavity in real time , which is conducive to timely adjustment of the treatment plan.

2. Postpartum forceps curettage

Postpartum forceps curettage is what we often call uterine curettage. The postpartum uterus is large, and when the instrument is difficult to reach the fundus, it is less likely to rely on forceps to remove it, so it should not be done reluctantly. If the patient has obvious active bleeding during the operation, it should be considered that the effect of curettage operation is not good, and other treatment measures should be used in time.


3. Pressure suturing

This method is an indirect way to achieve the goal of compression and hemostasis through surgical sutures. The most classic is the B-Lynch suture, which is well known to obstetricians. On this basis, various improved surgical methods have been derived. The biggest limitation of pressure suturing is that it can only be performed in an open setting, and in most cases it is actually an additional operation of cesarean section.


4. Intervention

Interventional therapy has attracted more and more attention under the current medical background of increasing high-risk pregnancy, especially in placenta implantation and postpartum hemorrhage, and has gradually become a common clinical technique. Although the operation is performed under the guidance of X-rays, the therapeutic effect of intervention relies on the physical interception of blood flow by blocking the vascular cavity, and does not depend on the patient's body's response to drugs, nor is it affected by the development of the disease, so it is still a part of physical therapy.