Uterine healing after therapeutic intrauterine administration of TachoSil (hemostatic fleece) in cesarean section with postpartum hemorrhage caused by placenta previa

Katrine Fuglsang, Margit Dueholm, Estrid Stæhr-Hansen, Lone Kjeld Petersen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND: Application of hemostatic fleece (TachoSil) directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa.

METHODS: Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing.

RESULTS: Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects.

CONCLUSION: TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility.

OriginalsprogEngelsk
TidsskriftJournal of Pregnancy
Vol/bind2012
Sider (fra-til)635683
ISSN2090-2727
DOI
StatusUdgivet - 2012

Fingeraftryk

Placenta Previa
Postpartum Hemorrhage
Hemostatics
Endometrium
Hysteroscopy
Uterus
Mucous Membrane
Outcome Assessment (Health Care)

Citer dette

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title = "Uterine healing after therapeutic intrauterine administration of TachoSil (hemostatic fleece) in cesarean section with postpartum hemorrhage caused by placenta previa",
abstract = "BACKGROUND: Application of hemostatic fleece (TachoSil) directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa.METHODS: Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing.RESULTS: Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects.CONCLUSION: TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility.",
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author = "Katrine Fuglsang and Margit Dueholm and Estrid St{\ae}hr-Hansen and Petersen, {Lone Kjeld}",
year = "2012",
doi = "10.1155/2012/635683",
language = "English",
volume = "2012",
pages = "635683",
journal = "Journal of Pregnancy",
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Uterine healing after therapeutic intrauterine administration of TachoSil (hemostatic fleece) in cesarean section with postpartum hemorrhage caused by placenta previa. / Fuglsang, Katrine; Dueholm, Margit; Stæhr-Hansen, Estrid; Petersen, Lone Kjeld.

I: Journal of Pregnancy, Bind 2012, 2012, s. 635683.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Uterine healing after therapeutic intrauterine administration of TachoSil (hemostatic fleece) in cesarean section with postpartum hemorrhage caused by placenta previa

AU - Fuglsang, Katrine

AU - Dueholm, Margit

AU - Stæhr-Hansen, Estrid

AU - Petersen, Lone Kjeld

PY - 2012

Y1 - 2012

N2 - BACKGROUND: Application of hemostatic fleece (TachoSil) directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa.METHODS: Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing.RESULTS: Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects.CONCLUSION: TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility.

AB - BACKGROUND: Application of hemostatic fleece (TachoSil) directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa.METHODS: Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing.RESULTS: Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects.CONCLUSION: TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility.

KW - Adult

KW - Biopsy

KW - Cesarean Section

KW - Cicatrix/diagnostic imaging

KW - Drug Combinations

KW - Endometrium/pathology

KW - Endotamponade/methods

KW - Female

KW - Fibrinogen/therapeutic use

KW - Follow-Up Studies

KW - Hemostatics/therapeutic use

KW - Humans

KW - Hysteroscopy

KW - Placenta Previa

KW - Postpartum Hemorrhage/etiology

KW - Pregnancy

KW - Surgical Sponges

KW - Thrombin/therapeutic use

KW - Tissue Adhesions/etiology

KW - Treatment Outcome

KW - Ultrasonography

KW - Uterus/diagnostic imaging

U2 - 10.1155/2012/635683

DO - 10.1155/2012/635683

M3 - Journal article

VL - 2012

SP - 635683

JO - Journal of Pregnancy

JF - Journal of Pregnancy

SN - 2090-2727

ER -