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Background <p>Postpartum hemorrhage (PPH) causes 27% of maternal deaths globally. This study investigates the efficacy of the novel Transvaginal Uterine Artery Clamp (TVUAC) as a second-line intervention for controlling post partum hemorrhage (PPH).</p> Methods <p>This descriptive, observational study enrolled 254 patients with PPH (&gt; 500&#xa0;ml) following vaginal deliveries unresponsive to uterotonics at a tertiary care centre in Kolkata, India over a period of 18&#xa0;months. Post Vaginal delivery, when uterotonics failed to control PPH, TVUAC were applied bilaterally thereby occluding the uterine arteries providing immediate hemostasis. Data collection and relevant statistical analysis were performed.&#xa0;Primary outcomes included the TVUAC success rate, requirement of third-line surgical interventions, and factors associated with failure.</p> Results <p>TVUAC successfully controlled PPH in 97% cases (247/254; 95% CI 94.6–98.6%), with only 3% (7/254; 95% CI 1.4–5.4%) requiring laparotomy. Clamp failure was significantly higher in referred cases (16.7%, <i>p</i> = 0.034), instrumental deliveries (33.3%, <i>p</i> = 0.02), and those with hypertensive disorders (6%). No maternal deaths or recurrent PPH occurred among successful cases. All patients received blood transfusions, with a moderate positive correlation between uncontrolled PPH and the need for ≥ 5 units of blood products.</p> Conclusions <p>TVUAC, an effective, minimally invasive, and accessible second line intervention, offers a scalable solution for resource limited settings. Its potential to transform PPH management can reduce maternal mortality by either immediate control or limiting blood loss during transport to higher facility.</p>

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Transvaginal Uterine Artery Clamp—A Low-Cost Lifesaver for Post Partum Hemorrhage in Resource Limited Settings: A Descriptive Study

  • 期刊论文

  • 发表日期：

    2026年1月30日

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  • Riya Bera,
  • Ajanta Samanta,
  • Aparna Chakraborty,
  • Abhimanyu Gayen,
  • Chiranjit Ghosh,
  • Subrata Lall Seal

摘要

Background

Postpartum hemorrhage (PPH) causes 27% of maternal deaths globally. This study investigates the efficacy of the novel Transvaginal Uterine Artery Clamp (TVUAC) as a second-line intervention for controlling post partum hemorrhage (PPH).

Methods

This descriptive, observational study enrolled 254 patients with PPH (> 500 ml) following vaginal deliveries unresponsive to uterotonics at a tertiary care centre in Kolkata, India over a period of 18 months. Post Vaginal delivery, when uterotonics failed to control PPH, TVUAC were applied bilaterally thereby occluding the uterine arteries providing immediate hemostasis. Data collection and relevant statistical analysis were performed. Primary outcomes included the TVUAC success rate, requirement of third-line surgical interventions, and factors associated with failure.

Results

TVUAC successfully controlled PPH in 97% cases (247/254; 95% CI 94.6–98.6%), with only 3% (7/254; 95% CI 1.4–5.4%) requiring laparotomy. Clamp failure was significantly higher in referred cases (16.7%, p = 0.034), instrumental deliveries (33.3%, p = 0.02), and those with hypertensive disorders (6%). No maternal deaths or recurrent PPH occurred among successful cases. All patients received blood transfusions, with a moderate positive correlation between uncontrolled PPH and the need for ≥ 5 units of blood products.

Conclusions

TVUAC, an effective, minimally invasive, and accessible second line intervention, offers a scalable solution for resource limited settings. Its potential to transform PPH management can reduce maternal mortality by either immediate control or limiting blood loss during transport to higher facility.