title: Uterine healing after therapeutic intrauterine administration of TachoSil (hemostatic fleece) in cesarean section with postpartum hemorrhage caused by placenta previa.
abstract: BACKGROUND
  Application of hemostatic fleece (TachoSil) directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa.
  
  
  METHODS
  Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing.
  
  
  RESULTS
  Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects.
  
  
  CONCLUSIONS
  TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital of Aarhus, Skejby Sygehus, 8200 Aarhus N, Denmark. katrfugl@rm.dk
authors.forename: Katrine
authors.initials: K
authors.lastname: Fuglsang
authors.forename: Margit
authors.initials: M
authors.lastname: Dueholm
authors.forename: Estrid
authors.initials: E
authors.lastname: Stæhr-Hansen
authors.forename: Lone Kjeld
authors.initials: LK
authors.lastname: Petersen
mesh_terms: D000328:Adult; D001706:Biopsy; D002585:Cesarean Section; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000473:pathology; D004338:Drug Combinations; D004717:Endometrium / Q000473:pathology; D058450:Endotamponade / Q000379:methods*; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D015907:Hysteroscopy; D010923:Placenta Previa; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D015503:Surgical Sponges; D013917:Thrombin / Q000627:therapeutic use*; D000267:Tissue Adhesions / Q000209:etiology; D016896:Treatment Outcome; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D004338:Drug Combinations; D006490:Hemostatics; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin