title: A local hemostatic agent for the management of postpartum hemorrhage due to placenta previa and placenta accreta: a cross-sectional study.
abstract: OBJECTIVE
  To describe the use of a local hemostatic agent (LHA) for the management of postpartum hemorrhage (PPH) due to bleeding of the placental bed in patients taken to caesarean section at Fundación Santa Fe de Bogotá University Hospital.
  
  
  METHODS
  A total of 41 pregnant women who had a caesarean section and developed PPH.
  
  
  METHODS
  A cross-sectional study. Analysis of all cases of PPH during caesarean section presented from 2006 up to and including 2012 at Fundación Santa Fe de Bogotá University Hospital.
  
  
  METHODS
  Emergency hysterectomy due to PPH.
  
  
  RESULTS
  The proportion of hysterectomies was 5 vs. 66 % for the group that received and did not receive management with a LHA respectively (PR 0.07, CI 95 % 0.01-0.51 p < 0.01). For the group managed without a LHA, 80 % of patients needed hemoderivatives transfusion vs. 20 % of patients in the group managed with a LHA (PR 0.24, CI 95 % 0.1-0.6 p < 0.01). A reduction in the mean days of hospitalization in addition to a descent in the proportion of patients admitted to the intensive care unit (ICU) was noticed when comparing the group that received a LHA versus the one that did not.
  
  
  CONCLUSIONS
  An inverse association between the use of a LHA in patients with PPH due to bleeding of the placental bed and the need to perform an emergency obstetric hysterectomy was observed. Additionally there was a significant reduction in the mean duration of hospital stay, use of hemoderivatives and admission to the ICU.
authors.affiliation: Gynecology, Obstetrics and Human Reproduction Department, Fundación Santa Fe de Bogotá Teaching Hospital, Bogotá, Colombia. neodifepo@gmail.com
authors.forename: Diego
authors.initials: D
authors.lastname: Portilla
authors.forename: Cristian
authors.initials: C
authors.lastname: Hernández-Giraldo
authors.forename: Bernardo
authors.initials: B
authors.lastname: Moreno
authors.forename: Fabio
authors.initials: F
authors.lastname: Quijano
authors.forename: Luis R
authors.initials: LR
authors.lastname: Hoyos
authors.forename: Ana Milena
authors.initials: AM
authors.lastname: Angarita
authors.forename: Santiago
authors.initials: S
authors.lastname: Madero
mesh_terms: D000328:Adult; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007902:Length of Stay; D010921:Placenta Accreta; D010923:Placenta Previa; D006473:Postpartum Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy
chemical_list: D002483:Cellulose, Oxidized; D006490:Hemostatics; C013695:Surgicel