What is the role of hysterectomy in the treatment of postpartum hemorrhage (PPH)?

Updated: Jun 27, 2018
  • Author: John R Smith, MD, FACOG, FRCSC; Chief Editor: Ronald M Ramus, MD  more...
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Answer

Hysterectomy is curative for bleeding arising from the uterine, cervical, and vaginal fornices. The procedure of peripartum hysterectomy is well described in several texts and articles (eg, Hysterectomy), and the technique differs little from that in nonpregnant patients. [67, 63] While the organ is more vascular, the tissue planes are often more easily developed. Total hysterectomy is preferred to subtotal hysterectomy, although the latter may be performed faster and be effective for bleeding due to uterine atony. Subtotal hysterectomy may not be effective for controlling bleeding from the lower segment, cervix, or vaginal fornices. Take every opportunity to become involved when peripartum hysterectomies are performed.


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