Uterine preservation surgery in severe postpartum haemorrhage: What impact on reproductive function?

Abstract

Introduction: Postpartum haemorrhage (PPH) remains one of the most risky situations in obstetrics and major cause of maternal morbidity and mortality worldwide. There can be major psychological sequelae also. Treatment options for PPH include conservative management with uterotonic drugs, selective devascularization by ligation or embolization of the uterine artery, external compression with uterine sutures, intrauterine balloon and hysterectomy. This last issue adds to the maternal drama of a situation with definitive infertility. The choice of treatment depends on several factors: delivery mode, the site of origin and volume of bleeding, the patient's hemodynamic tolerance, the technical possibility and the surgical skills.