Table 2

First-line and second-line measures in women undergoing hysterectomy (H) and/or interventional radiology (IR) according to the circumstances of the obstetric haemorrhage

Total n=166
n (%)
Planned H and/or IR, n=15
n (%)
Urgent H and/or IR, n=151
IR service 24/7, n=98
n (%)
IR service not 24/7, n=12
n (%)
No IR service, n=25
n (%)
Postnatal transfer, n=16*
n (%)
Cause of obstetric haemorrhage
 Abnormal placentation56 (34)15 (100)29 (30) 5 (42)5 (20)2 (13)
 Atony only43 (26) —29 (30)5 (42)7 (28)2 (13)
 Uterine rupture  12 (7) — 6 (6) 1 (8)5 (20)
 Miscellaneous†55 (33) —34 (34) 1 (8)8 (32)12 (75)
First-line and second-line measure
 Uterotonics134 (81)10 (67)81 (83)10 (83)19 (76)15 (94)
 Oxytocin123 (74)10 (67)73 (75) 9 (75)18 (72)13 (81)
 PG109 (66) 5 (33)64 (65)17 (68)8 (67)15 (94)
 Misoprostol61 (37) 1 (7)34 (35) 6 (50)10 (40)10 (63)
 Carboprost63 (39) 5 (33)42 (43) 3 (25)9 (25)9 (56)
 Oversewing‡30 (18) 1 (7)19 (20) 1 (8)7 (28)2 (13)
 (Bimanual) compression64 (39) 3 (20)36 (37) 5 (42)9 (36)11 (69)
 Balloon tamponade35 (21) 2 (13)21 (22) 2 (17)3 (12)7 (44)
 B-lynch or ligation  10 (6) 5 (5) 1 (8)4 (16)
 Transfusion139 (84) 7 (47)85 (87)12 (100)21 (84)15 (88)
 Massive transfusion§51 (31) 2 (13)24 (24) 7 (58)10 (40)8 (50)
 Fresh frozen plasma108 (65) 4 (27)64 (65)11 (92)18 (72)11 (69)
 Platelets57 (34) 1 (7)29 (30) 9 (75)10 (40)8 (50)
 Clotting factors¶23 (14) — 8 (8) 5 (42)7 (28)3 (19)
  • *One woman was transferred postnatally for persistent bleeding due to abnormally invasive placenta despite planned IR in the referring hospital; she was included in the ‘planned’ group.

  • †Miscellaneous group: placental remnants or retention n=25, surgical trauma n=16, genital tract laceration n=11, intra-abdominal arterial bleeding n=4, coagulation disorders n=3, unknown n=6. The total number exceeds n=55 due to overlap in between cases.

  • ‡Oversewing of the placental implantation site, bleeding points, tears or ruptures.

  • §Massive transfusion: transfusion of 8 or more units of red blood cells.

  • ¶Clotting factors: fibrinogen, recombinant factor VIIa, prothrombin-proconvertin-Stuart factor-antihaemophilic factor B, or a combination.

  • PG, prostaglandin. This can be any or a combination of the following: misoprostol, sulprostone, dinoprostone, carboprost.