OBJECTIVE

To evaluate the effectiveness of the proposed algorithm of obstetric bleeding cessation using a new method — elastic uterine compression in single and multiple births.

MATERIAL AND METHODS

We analyzed 20.321 patients, including 19.204 (94.5%) with singleton pregnancies and 111 (5.5%) with multiple pregnancies; 16.150 (79.5%) patients were delivered vaginally and 4171 (20.5%) patients underwent cesarean section. The retrospective cohort study included 1051 patients with obstetric hemorrhage. Medical care in case of postpartum hemorrhage was provided in accordance with the developed local algorithm, including elastic uterine compression (EUC). EUC was performed after removal of the uterus from the abdominal cavity by placing a sterile dry elastic bandage on it and then immersing it in a sterile polyethylene bag to prevent hypothermia during cesarean section or laparotomy after vaginal delivery. Determination of stage and final obstetric blood loss at each delivery was performed by gravimetric and volumetric methods.

RESULTS

The analysis of the results showed that the final volume of blood loss at uterine hypotony and isolated application of EUC was significantly less than at treating the bleeding by ligation of the main uterine arteries from both sides and subsequent application of EUC, which gives special importance to EUC as an independent method of surgical hemostasis of the first line. In almost every fourth patient EUC was the only method of complete stopping of postpartum hemorrhage.

CONCLUSION

EUC is a simple in execution, effective, economical, complication-free method of complete temporary cessation of obstetric uterine bleeding and in almost one quarter of patients with postpartum hemorrhage it allows to avoid ligation of internal iliac arteries and hysterectomies.