Optimal management of postpartum hemorrhage.

Objective: To review the management of postpartum hemorrhage (PPH).

Methods: Fifteen cases of severe PPH were retrospectively analyzed for clinical parameters and management.

Results: Nine patients had a hysterectomy while selective arterial embolization was carried out in 7 cases. One patient had focus clearance. The main causes of postpartum hemorrhage requiring operative management were disseminated intravascular coagulation (DIC), uterine arteriovenous fistula and malformation, placental abnormality, uterine myoma and laceration.

Conclusions: Upon recognition of postpartum hemorrhage, the most effective management should be initiated. Every effort should be made to stabilize the patient and maintain her reproductive capability.