Intrauterine irrigation with prostaglandin F2-α for management of severe postpartum hemorrhage

Michael J. Kupferminc*, Ilan Gull, Amiram Bar-am, Yair Daniel, Ariel Jaffa, Michael Shenhav, Joseph B. Lessing

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background. Severe postpartum hemorrhage is a significant contributor to maternal morbidity and mortality. The use of prostaglandin F2-α to control severe postpartum hemorrhage may avert surgery for the control of bleeding. Methods. After ruling out the possibility of genital tract injuries, 18 patients with severe postpartum hemorrhage caused by uterine atony were enrolled in the study. None of the patients responded to treatment with oxytocin, methylergonovine, or uterine massage. A Foley catheter was introduced into the uterine cavity and the balloon was inflated with 5 ml sterile saline solution. The catheter was connected to an infusion line of 500 ml saline solution containing 20 mg prostaglandin F2-α. The solution was infused at a rate of 3-4 ml/minute for the first 10 min, and then reduced to 1 ml/minute for a period of 12-24 hours. Results. In 17 patients (94.4%) bleeding ceased within several minutes of initiation of intrauterine prostaglandin F2-α infusion, the uterus was firmly contracted and uterine bleeding did not recur. In one patient with placenta increta bleeding continued and hysterectomy was performed. None of the patients had any side effects. Conclusions. Intrauterine irrigation with low concentrations of prostaglandin F2-α is a simple, rapid and effective treatment for severe postpartum hemorrhage and facilitates constant and continuous hemostasis. Moreover, the minute dosage used eludes potentially complicating side effects.

Original languageEnglish
Pages (from-to)548-550
Number of pages3
JournalActa Obstetricia et Gynecologica Scandinavica
Volume77
Issue number5
DOIs
StatePublished - 1998

Keywords

  • Intrauterine irrigation
  • Prostaglandin F-α
  • Severe postpartum hemorrhage

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