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Case 63 - A 20-Year-Old with Vaginal Bleeding and Enlarging Fundus Following a Cesarean Delivery

from Section 7 - Postpartum

Published online by Cambridge University Press:  08 April 2025

By
Aaron Goldberg
Edited by
Peter F. Schnatz ,
D. Yvette LaCoursiere ,
Christopher M. Morosky ,
Jonathan Schaffir ,
Vanessa Torbenson  and
David Chelmow
Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
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Summary

Postpartum hemorrhage (PPH) is the most common cause of maternal mortality worldwide and uterine atony is the most common cause of PPH. Timely diagnosis and prompt intervention are crucial to manage this potentially life-threatening condition. Early blood product replacement and interventions aimed at reducing bleeding and restoring uterine contractility are key components of treatment. A progression of medical therapy, uterine compression, and surgical intervention may be needed to resolve the PPH. A standardized approach to management of PPH due to atony can help improve outcomes. The Alliance for Innovation on Maternal Health provides information regarding care bundles addressing a multidisciplinary approach to treating PPH and may be a resource for labor and delivery units in their efforts to improve care.

Keywords

postpartum hemorrhageuterine atonymaternal mortalitytransfusionuterotonics
Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
 , pp. 193 - 195
Publisher: Cambridge University Press
Print publication year: 2025

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References

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Zwart, JJ, Dijk, PD, van Roosmalen, J. Peripartum Hysterectomy and Arterial Embolization for Major Obstetric Hemorrhage: A 2-Year Nationwide Cohort Study in the Netherlands. Am J Obstet Gynecol. 2010;202:150.e1–150.e7.Google ScholarPubMed
Hayman, RG, Arulkumaran, S, Steer, PJ. Uterine Compression Sutures: Surgical Management of Postpartum Hemorrhage. Obstet Gynecol. 2002;99:502–506.Google ScholarPubMed
B-Lynch, C, Coker, A, Lawal, AH, Abu, J. Cowen, MJ. The B-Lynch Surgical Technique for the Control of Massive Postpartum Hemorrhage: An Alternative to Hysterectomy? Five Cases Reported. Br J Obstet Gynaecol. 1997;104:372–375.CrossRefGoogle ScholarPubMed

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