New local hemostatic treatment for postpartum hemorrhage caused by placenta previa at cesarean section.

Acta Obstet Gynecol Scand 89(10):1346-9 (2010) PMID 20521867

Cesarean section in women with placenta previa is associated with the risk of heavy bleeding. We describe a new method where local hemostasis is obtained by applying a hemostatic fleece directly onto the lower uterine segment. During a 2-year period women undergoing cesarean section due to placenta previa were treated with this hemostatic fleece if they had ongoing bleeding during the surgical procedure despite routine treatment. Data were obtained retrospectively from the hospital records. Fifteen patients were treated by 15 different surgeons. No patients required reoperation. Three patients required blood transfusion due to anemia. No patients were readmitted to the hospital due to endometritis. We conclude that the application of a hemostatic fleece directly onto the bleeding surfaces in patients with post-cesarean bleeding due to placenta previa is technically unproblematic. The results suggest that this procedure should be considered in case of bleeding after delivery in women with placenta previa.