Articles Related to Uterine atony
By reporting a case series from a referral hospital we aimed to determine the treatment options and outcomes of one of the serious complications of the labour uterine atony refractory to the medical treatment. In this study, a total of 58 postpartum uterine atony cases refractory to uterotonic treatment and managed with intrauterine balloon tamponade, B-Lynch suture, internal iliac artery ligation or hysterectomy was a retrospectively analyzed. Initially, thirty two cases managed with intrauterine Bakri balloon tamponade and six B-Lynch compression sutures alone, in eight cases both procedures were done together. Eight cases managed with internal iliac artery ligation and four hysterectomies. Our success rate with intrauterine Bakri balloon tamponade, B-Lynch compression suture and internal iliac artery ligation were 84.4%, 83.3%, 75% respectively in stopping postpartum haemorrhage regarding uterine atony and the most successfull rate was obtained with the Bakri balloon tamponade in the combination with B-Lynch compression suture 87.5%. The median estimated blood loss was 2018ml, intraoperative median hemoglobin was 5.8 mg/dl and the median amount of blood transfused was five units, the median volume infused into balloon was 285ml; balloon was in place for a median duration of 36 hours. In 6 cases Bakri balloon tamponade with or without B-Lynch compression sutures failed to stop haemorrhage and hysterectomy required. In two patients Asherman’s syndrome and infertility, in two patients’ amenore were developed and uterine prolapse was observed in 2 patients, one of which was uterine necrosis. No maternal mortality was observed.
Effects of Oxytocin and Carbetocin on Haemostatic Variables in Pregnant Women after Cesarean Section
Uterine atony is the first cause of haemorrhage at delivery. To prevent post partum major bleeding uterotonic prophylactic drugs are commonly used after caesarean section. Few studies showed an haemostatic activation after oxytocin infusion while no data are available on carbetocin.