Laparoscopic temporary clipping of the uterine arteries in massive postpartum haemorrhage: a new method of management? – Treatement of PPH by laparoscopy

Presentation is made of a novel treatment approach in a case of massive late postpartum haemorrhage ten days after caesarean delivery of premature twins by laparoscopic placement of YASARGIL aneurysm clips to the uterine arteries.

We describe a case of a patient with major late PPH successfully managed by laparoscopic placement of YASARGIL aneurysm clips on the uterine arteries.

The patient presented with massive secondary postpartum haemorrhae, which initially responded to conservative treatement, such as Oxitocin, Misoprostol, Nalador and uterine massage. Two hours after the first episode of bleeding, uterine atony recurred. Hence a laparoscopic approach was chosen. On each uterine artery a clip, generally used for the treatement of cerebral aneurism, a YASARGIL clip, was placed. This novel approach successfully stopped the exessive bleeding through uterine atony avoiding laparotomy.

To the best of our knowledge, this is the first report on this novel laparoscopic surgical approach in achieving haemostasis in major PPH.