Research Article| Volume 7, ISSUE 4, P883-897, October 1991

Postpartum Hemorrhage

  • Michael Varner
    Address reprint requests to: Michael Varner, MD, Department of Obstetrics and Gynecology, University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132
    Professor, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah
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      Early postpartum hemorrhage (PPH) remains a significant cause of maternal morbidity and mortality. Many cases occur in women with antecedent risk factors and can thus be anticipated, promptly diagnosed, and promptly treated. PPH is most commonly due to uterine atony and often responds to medical management. Surgical intervention, either to repair lacerations, transiently reduce pelvic pulse pressure, or remove the uterus, can be life saving.
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        • Benrubi G.
        • Neuman C.
        • Nuss R.C.
        • et al.
        Vulvar and vaginal hematomas: A retrospective study of conservative versus operative management.
        South Med J. 1987; 80: 991
        • Brown B.J.
        • Heaston D.K.
        • Poulson A.M.
        • et al.
        Uncontrollable postpartum bleeding: A new approach to hemostasis through angiographic arterial embolization.
        Obstet Gynecol. 1979; 54: 361
        • Bruce S.L.
        • Paul R.H.
        • Van Dorsten J.P.
        Control of postpartum uterine atony by intramyometrial prostaglandin.
        Obstet Gynecol. 1982; 59: 47S
        • Burchell R.C.
        Physiology of internal iliac artery ligation.
        Obstet Gynecol. 1964; 24: 737
        • Cassels J.W.
        • Greenberg H.
        • Otterson W.N.
        Pelvic tamponade in puerperal hemorrhage.
        J Reprod Med. 1985; 30: 689
        • Catanzarite V.A.
        • Moffitt K.D.
        • Baker M.L.
        • et al.
        New approaches to the management of acute puerperal uterine inversion.
        Obstet Gynecol. 1986; 68: 75
        • Chin H.G.
        • Scott D.R.
        • Resnik R.
        • et al.
        Angiographic embolization of intractable puerperal hematomas.
        Am J Obstet Gynecol. 1989; 160: 434
        • Clark S.L.
        • Koonings P.P.
        • Phelan J.P.
        Placenta previa-accreta and previous cesarean section.
        Obstet Gynecol. 1985; 66: 89
        • Clark S.L.
        • Phelan J.P.
        • Yeh S.Y.
        • et al.
        Hypogastric artery ligation for obstetric hemorrhage.
        Obstet Gynecol. 1985; 66: 353
        • Clark S.L.
        • Yeh S.Y.
        • Phelan J.P.
        • et al.
        Emergency hysterectomy for obstetric hemorrhage.
        Obstet Gynecol. 1984; 64: 376
        • Cruikshank S.H.
        • Stoelk E.
        Surgical control of pelvic hemorrhage: Bilateral hypogastric artery ligation and method of ovarian artery ligation.
        South Med J. 1985; 78: 539
        • Dewhurst C.J.
        • Dutton W.A.W.
        Recurrent abnormalities of the third stage of labor.
        Lancet. 1957; 2: 764
        • Dieckmann W.J.
        • O’Dell L.D.
        • Williger V.M.
        • et al.
        The placental stage and postpartum hemorrhage.
        Am J Obstet Gynecol. 1947; 54: 415
        • Druzin M.
        • Wolf C.R.W.
        • Edersheim T.G.
        • et al.
        Donation of blood by the pregnant patient for autologous transfusion.
        Am J Obstet Gynecol. 1988; 159: 1023
        • Eggers T.R.
        • Fliegner J.R.
        Water intoxication and syntocinon intoxication.
        Aust NZ J Obstet Gynaecol. 1979; 19: 59
        • Evans S.
        • McShane P.
        The efficacy of internal iliac artery ligation in obstetric hemorrhage.
        Surg Gynecol Obstet. 1985; 160: 250
        • Fuchs K.
        • Peretz B.A.
        • Marcovici R.
        • et al.
        The “grand multipara”—is it a problem? A review of 5785 cases.
        Int J Gynaecol Obstet. 1985; 23: 321
        • Gilbert L.
        • Porter W.
        • Brown V.A.
        Postpartum hemorrhage—a continuing problem.
        Br J Obstet Gynaecol. 1987; 94: 67
        • Hall M.
        • Marshall J.R.
        The gravity suit: A major advance in management of gynecologic blood loss.
        Obstet Gynecol. 1979; 53: 361
        • Hankins G.D.V.
        • Berryman G.K.
        • Scott R.T.
        • et al.
        Maternal arterial desaturation with 15-methyl prostaglandin F2a for uterine atony.
        Obstet Gynecol. 1988; 72: 367
        • Hayashi R.H.
        • Castillo M.S.
        • Noah M.L.
        Management of severe postpartum hemorrhage due to uterine atony using an analogue of prostaglandin F2a.
        Obstet Gynecol. 1981; 58: 426
        • Kaimitz A.M.
        • Hughes J.M.
        • Grimes D.A.
        • et al.
        Causes of maternal mortality in the United States.
        Obstet Gynecol. 1985; 65: 605
        • Kitchin J.D.
        • Thiagarajah S.
        • May H.V.
        • et al.
        Puerperal inversion of the uterus.
        Am J Obstet Gynecol. 1975; 123: 51
        • Lee C.Y.
        • Madrazo B.
        • Drukker B.H.
        Ultrasonic evaluation of the postpartum uterus in the management of postpartum bleeding.
        Obstet Gynecol. 1981; 58: 227
        • Pritchard J.A.
        • Baldwin R.M.
        • Dickey J.C.
        • et al.
        Blood volume changes in pregnancy and the puerperium. II. Red blood cell loss and changes in apparent blood volume during and following vaginal delivery, cesarean section, and cesarean section plus total hysterectomy.
        Am J Obstet Gynecol. 1962; 84: 1271
        • Sheth S.S.
        Results of treatment of rupture of the uterus by suturing.
        Journal of Obstetrics and Gynaecology of the British Commonwealth. 1968; 75: 55
        • Terasaki K.K.
        • Quinn M.F.
        • Lundell C.J.
        • et al.
        Spontaneous hepatic hemorrhage in pre-eclampsia: Treatment with hepatic arterial embolization.
        Radiology. 1990; 174: 1039
        • Watson P.
        • Beach N.
        • Bowes W.A.
        Management of acute and subacute puerperal inversion of the uterus.
        Obstet Gynecol. 1980; 55: 12
        • Zahn C.M.
        • Yeomans E.R.
        Postpartum hemorrhage: Placenta accreta, uterine inversion, and puerperal hematomas.
        Clin Obstet Gynecol. 1990; 33: 422