This article examines hemorrhages and peripartum hysterectomies.
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Hysterectomy is an uncommon procedure for the obstetric patient. It is a procedure reserved to be lifesaving and the indications for its use are associated with maternal morbidity and mortality. Hysterectomy is a final endpoint for postpartum hemorrhage protocols, but the success of protocols requires early identification and active management of bleeding patients. Postpartum hemorrhage from uterine atony remains the most common indication for peripartum hysterectomy. Uterotonics, balloon tamponade, and postpartum hemorrhage protocols remain the first steps in managing postpartum hemorrhage. Postpartum hemorrhage unresponsive to uterotonics and compression may be
caused by genital tract laceration, coagulopathy, or abnormally invasive
placentation. Early and aggressive use of massive transfusion protocols may prevent large blood volume loss. Multidisciplinary teams along with improvements in interventional radiology achieve improved outcomes for complicated postpartum patients.
