Pharmacotherapy of Massive Obstetric Bleedings as Alternative to Hysterectomy

Abstract

Modern society with its bad ecology, chronic stress and the prevalence of mental activities over physical no longer treats pregnancy as a physiological state with natural course of events but the state that requires intensive medical supervision, active, even invasive, intervention during pregnancy and delivery. In most cases such intervention is the only way to save life for a mother and her child. Therefore, modern obstetrics is primarily a surgical one. With the overall growth of obstetric operations a number of radical interventions to remove the reproductive organ is also increasing .The main cause of hysterectomy and sometimes death of a patient in obstetric practice is massive obstetric hemorrhage (postpartum haemorrhage PPH). Life-threatening bleeding occurs in about 10% of deliveries worldwide (The Department of Health UK. Why mothers die. A report.., 2004). Obstetric hemorrhage is a major cause of maternal mortality, with 25 30% of overall death cases in prergnancy (Bonnar, 2000; Make Every Mather and Child count: the World Health Report.: WHO, 2005). The occurance of massive obstetric hemorrhage in developed and developing countries differs greatly (Ben Hあmid et al., 2006; Sheiner et al., 2005). The risk to die from obstetric hemorrhage in developed countries is 1:100 000, while in developing countries the rate reaches 1: 1000 births (Mousa & Alfirevic, 2003). According to WHO bleeding is among the big five of causes of maternal mortality that leads to an on-going research to find various methods to stop bleeding, as well as blood transfusion (Baudo et al., 2001).