Surgical Approach to Postpartum Hemorrhage After Uterine Atony

Transvaginal hemostatic surgery may be a safe and efficacious treatment option for individuals with early postpartum hemorrhage from lower uterine segment atony.

Researchers conducted a retrospective clinical study from 2010 to 2019 at a tertiary perinatal university center. Included were 29,543 deliveries, of which 0.72% (n=215) had early postpartum hemorrhage. Of the individuals with early postpartum hemorrhage, 29.93% (n=44) were due to uterine atony.

The results indicated that hemostatic ligation was used in 72.72% of cases (n=32). Hemostatic ligation alone or combined with gauze or balloon tamponade (n=5) was highly effective in 84.09% of cases (n=37).

“Lower uterine segment atony should definitely be identified and understood as a clinical entity,” researchers concluded. “Transvaginal hemostatic approach for surgical treatment of lower uterine segment atony is accessible, minimally invasive, feasible, successful and lifesaving. All of the above-mentioned methods are of great importance in the prevention and treatment of obstetric shock, multiorgan failure, postpartum hysterectomy and finally vital for fertility preservation.”


—Leigh Precopio



Habek D, Marton I, Prka M, Luetić AT, Vitić M, Jurković AM. Transvaginally surgically treatment of early postpartum hemorrhage caused by lower uterine segment. J Perinat Med. Published online May 9, 2022. doi:10.1515/jpm-2021-0686