The relationship between timing of postpartum hemorrhage interventions and adverse outcomes.
OBJECTIVE
We sought to determine whether the timing of balloon tamponade (BT) and uterine artery embolization is associated with morbidity among women with postpartum hemorrhage (PPH).


METHODS
This is a cohort study of women with PPH at a single tertiary academic institution. Patient demographics, delivery outcomes (eg, labor augmentation, route of delivery), and PPH-specific data (eg, estimated blood loss at the time when PPH interventions were employed) were abstracted from the chart. Outcomes studied included nadir hemoglobin, packed red blood cell transfusion, intensive care unit admission, and hysterectomy.


RESULTS
During the study period, 420 women were eligible for analysis. Women receiving BT at lower estimated blood loss quartiles had higher nadir hemoglobin, less frequent packed red blood cell transfusion, fewer intensive care unit admissions, and fewer hysterectomies. There were no associations found between timing of uterine artery embolization and maternal outcomes.


CONCLUSIONS
Earlier use of BT among women experiencing a PPH is associated with decreased maternal morbidity.
Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: Tera.f.howard@gmail.com.
Tera F
TF
Howard
Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
William A
WA
Grobman
D000328:Adult; D000740:Anemia / Q000378:metabolism / Q000628:therapy; D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000706:statistics & numerical data; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*; D058738:Uterine Balloon Tamponade / Q000379:methods*
D006454:Hemoglobins
balloon tamponade; maternal morbidity; postpartum hemorrhage