Risk factors and surgical interventions associated with primary postpartum haemorrhage unresponsive to first-line therapies

Abstract

The aim of this study was to investigate risk factors and surgical interventions associated with primary postpartum haemorrhage (PPH) unresponsive to first-line therapies. A retrospective analysis was performed of 212 women who experienced primary PPH (blood loss ≥ 500 ml). Logistic regression analysis identified that caesarean section (odds ratio [OR] 2.745; 95% confidence interval [CI], 1.063–7.085; p = 0.037) and abnormal placental adhesion (OR 3.823; 95% CI, 1.333–10.963; p = 0.013) were risk factors for PPH unresponsive to first-line therapies. There was no significant difference in blood loss, blood transfusion and success rate among intrauterine tamponade, B-Lynch suture and uterine artery ligation. Intrauterine tamponade is the least invasive and most rapid approach, so it should be taken as the first choice for surgical management after unresponsiveness to first-line therapies.

Keywords::

• B-Lynch suture
• intrauterine tamponade
• postpartum haemorrhage
• uterine artery ligation
• uterotonic

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This study was funded by the Key Project of Science and Technology Agency of Fujian Province, China (2009Y0008) and the Medical Innovation Project of Fujian Province Department of Science & Technology, China (2009-CXB-32).