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). STUDY DESIGN: 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. CONCLUSION: Earlier use of BT among women experiencing a PPH is associated with decreased maternal morbidity.