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Fırat Tıp Dergisi
2021, Cilt 26, Sayı 1, Sayfa(lar) 037-042
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Retrospective Analysis of Surgical Techniques Applied on Postpartum Hemorrhagic Cases
Adeviye ELÇİ ATILGAN, Ali ACAR, Fatma KILIÇ
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Konya, Türkiye

Objective: To determine the most effective surgical method in postpartum hemorrhagie cases, which is a preventable and also threatening mother\'s life.

Material and Method: This study was retrospectively reviewed from file archives and electronic files of the gynecology and obstetrics department of Meram University Hospital, focusing on patients who underwent a surgical procedure due to postpartum hemorrhagie (PPH) in the period of January 2010 to October 2014.Patients were divided in to three groups as Group I:B-Lynch +BHAL, Group II: Compression sutures and Group III:Acar technique.The demographic features of the groups, amount of blood loss, duration of surgery and hospitalization time were analysed and compared to detect most efficent technique for stopping PPH. Also, maternal death rate and the incidence of postpartum hysterectomy were evaluated.

Results:Totally 19535 deliveries accounted in this period. 48.6% of the deliveries were by cesarean and 52.4% by normal spontaneous vaginal route (NSR). In 320 of these patients (%1.62 ) PPH has occurred and 240 (75%) of them required surgical intervention. The most frequent etiologic cause for surgical intervention was uterine atony (n =88, 36.6%). The most effective surgical technique 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 1 mother died due to pulmonary embolism after hysterectomy at the first postoperative day.

Conclusion: In this study, we concluded that Acar technique was the most effective technic for PPH management. Even there are many other factors that will increase the incidence of PPH, such as increased cesarean ratio, placental adhesion anomalies, maternal age, multiple pregnancy, we need randomized controlled studies on this subject.


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