Invasive therapies for primary postpartum haemorrhage: a population-based study in France.

摘要: Objective To describe the characteristics, management, and outcomes of women undergoing invasive therapies for primary postpartum haemorrhage (PPH). Design A population-based observational study. Setting All 106 maternity units six French regions. Population A total 146 781 delivering between 2004 2006. Methods Prospective identification with PPH managed therapies, including uterine suture, pelvic vessel ligation, arterial embolisation, hysterectomy. Main outcome measures Rate use failure rate 95% confidence intervals (95% CIs). Results An therapy was used in 296 6660 (4.4%, 95% CI 4.0–5.0), 0.2% deliveries (95% CI 0.18–0.23). A hysterectomy performed 72/6660 (1.1%, 0.8–1.4%), 0.05% 0.04–0.06). conservative 262 women, 183 (70%) who underwent embolisation 79 (30%) had surgery as first-line therapy. Embolisation more frequently after vaginal than caesarean delivery, when available on site. The 41/262 (15.6%, 11.5–20.6) overall, higher surgical procedures, particular deliveries. Conclusions Both maternal mortality a result obstetric are high France. These findings suggest flaws initial management and/or inadequate procedures. Tweetable abstract Maternal