STUDY ON THE MANAGEMENT OUTCOMES OF POST-CESAREAN HEMORRHAGE IN IN VITRO FERTILIZATION PATIENTS AT THE NATIONAL HOSPITAL OF OBSTETRICS AND GYNECOLOGY
Main Article Content
Abstract
Objective: To evaluate certain characteristics of patients and management outcomes of postpartum hemorrhage (PPH) following cesarean section in in vitro fertilization (IVF) pregnancies at the National Hospital of Obstetrics and Gynecology during 2023–2024.
Methods: A cross-sectional descriptive study.
Results: There were 74 cases of IVF-associated PPH after cesarean section. The mean maternal age was 35,16 years; the rate of multiple pregnancies was 37,84 %; frozen embryo transfer accounted for 87,8 %; and elective cesarean section accounted for 86,5% of cases. The main causes of PPH were uterine atony (70,27%), placenta previa (18,91%), and placenta accreta (10,81%). Among cases of uterine atony, combined use of uterotonic drugs and uterine artery ligation was applied in 19,23%. For PPH due to placenta previa, the most common management methods were uterotonics with suturing of the bleeding placental site (35,7%) and uterine artery ligation (50%). In cases of placenta accreta, subtotal hysterectomy for hemostasis was performed in 50%. The uterine preservation rate in our study was 89,19%.
Conclusion: Management of intraoperative and postoperative hemorrhage after cesarean section in IVF pregnancies requires a multimodal approach depending on the underlying cause.
Article Details
Keywords
Postpartum hemorrhage after cesarean section, in vitro fertilization.
References
[2] Yunas I, Islam MA, Sindhu KN, Devall AJ, Podesek M, Alam SS, Kundu S, Mammoliti K-M, Aswat A, Price MJ, Zamora J, Oladapo OT, Gallos I, Coomarasamy A. Causes of and risk factors for postpartum haemorrhage: a systematic review and meta-analysis. Lancet. 2025 Apr 26;405(10488):1468–80.
[3] Nguyễn Thị Hiền. Nghiên cứu nguyên nhân và thái độ xử trí chảy máu sau đẻ tại Bệnh viện Phụ sản Trung ương [Luận văn Thạc sĩ Y học]. Hà Nội: Trường Đại học Y Hà Nội; 2016.
[4] Combs CA, Murphy EL, Laros RK. Factors associated with postpartum hemorrhage with vaginal birth. Br J Obstet Gynaecol. 1991;98(1):69–76.
[5] Bạch Thị Cúc. Nghiên cứu về chảy máu sau đẻ tại Bệnh viện Phụ sản Trung ương trong 2 năm 2008–2009 [Luận văn Bác sĩ chuyên khoa cấp II]. Hà Nội: Trường Đại học Y Hà Nội; 2010.
[6] Al-Khatib A, Sagot P, Cottenet J, Aroun M, Quantin C, Desplanches T. Major postpartum haemorrhage after frozen embryo transfer: a population-based study. BJOG. 2024;131(3):300–8. doi:10.1111/1471-0528.17625.
[7] Romundstad LB, Romundstad PR, Sunde A, von Düring V, Skjaerven R, Vatten LJ. Increased risk of placenta previa in pregnancies following IVF/ICSI: a comparison of ART and non-ART pregnancies in the same mother. Hum Reprod. 2006;21(9):2353–8. doi:10.1093/humrep/del153.
[8] Phạm Thị Hải. Nghiên cứu chảy máu sau đẻ tại Bệnh viện Phụ sản Trung ương từ 7/2004–6/2007 [Luận văn Thạc sĩ Y học]. Hà Nội: Trường Đại học Y Hà Nội; 2007.