title: Tisseel for management of traumatic postpartum haemorrhage.
abstract: BACKGROUND
  Following the introduction of haemostatic agents, new opportunities are available when facing problematic bleeding. We report the first case of traumatic postpartum hemorrhage successfully controlled with a fibrin sealant.
  
  
  METHODS
  26-year nulliparous patient had a rotational forceps delivery and developed multiple vaginal lacerations. Haemostasis could not be achieved after suturing, vaginal packing and IV tranaxemic acid. She lost approx. 3,500 ml blood and received 4 U transfusion. Tisseel was used as a thin layer on vaginal wall and bleeding settled. She had good recovery and perineum healed well.
  
  
  CONCLUSIONS
  Tisseel consists of a two-component fibrin biomatrix to stop diffuse bleeding. When the tissues are very oedematous, it can be difficult to insert sutures. We tried this innovative option with very effective results. The absence of long-term complications is reassuring and we recommend its use in similarly extreme situations.
authors.forename: Jaya Saxena
authors.initials: JS
authors.lastname: Dhulkotia
authors.forename: M
authors.initials: M
authors.lastname: Alazzam
authors.forename: A
authors.initials: A
authors.lastname: Galimberti
mesh_terms: D000328:Adult; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy
chemical_list: D015718:Fibrin Tissue Adhesive