Medical management of PPH with uterotonic drugs was successful in 30% of patients and these patients
Abstract
the use of tranexamic acid and misoprostol along with oxytocin in the treatment of PPH with significant decreases in rates of acute cases of PPH and mean blood loss.23-25 Uterine packing was done in 30 (43%) patients and bleeding was successfully arrested in 27 (90%) patients. Similar results were shown in a study conducted in 2008 by Khairunnisa where uterovaginal packing was successful in 89.14% of patients.26
Also in studies done by Ge J and GUO YN success rate was 92% and 90.9 % respectively.27,28 Thus uterine packing with an abdominal sponge or gynae gauze has proved to be an effective method for preventing PPH. B- Lynch was applied in 8 patients and bleeding was arrested in 6/8 (75%) patients. In a study conducted in Singapore, the b-lynch suture was successful in 71% of patients.29 Whereas a study conducted in Mumbai India by Nidhi kalkal showed that the procedure was successful in 100% of the cases.30 Internal iliac ligation was done in 1 (1.4%) patients which were not successful in our setup. VM Joshi in 2007 in India demonstrated that internal iliac artery ligation for arresting postpartum hemorrhage was successful in only 39% of cases.31
Timely recognition and intervention are fundamental in preventing serious maternal morbidity and mortality from massive PPH. A combination of conservative therapies is adequate and successful in most cases. However, when the hemorrhagic process continues and when either clotting abnormalities or h
