Intrauterine Vacuum-Induced Hemorrhage Management Shows Promise for Aberrant Postpartum Uterine Bleeding: Study
PPH (Post-Partum Haemorrhage) is a primary cause of significant maternal illness and death, resulting in up to 1.25 million maternal fatalities annually and affecting the health of 20 million women each year. Uterine atony is responsible for 70% of these occurrences.
Several studies have documented a rise in the occurrence of atonic PPH in recent years. While risk factors like extended labor, anemia, and large infants are associated with atonic PPH, the exact reasons why some women acquire this condition and others do not remain unclear. This situation is inherently unpredictable for the same reason. Medical or mechanical interventions can be used to treat atonic postpartum hemorrhage. Less complex methods like uterine massage, uterotonics medicines, uterine packing and balloon tamponade can be implemented in settings with limited resources.
Advanced medical centers provide techniques such as B Lynch suturing, stepwise devascularization, internal iliac ligation, and uterine artery embolization. These advanced treatments are not accessible to every woman in labor when the lesser ones are unsuccessful. Occasionally, women experience mortality within a short span of 1-2 hours following the commencement of bleeding.
If these methods fail, hysterectomy is the next option, which could be a life changing event, especially for young patients. If this can be prevented by alternative methods that are simpler and more effective, it could result in an improved outcome for the mother. An intervention avoiding hysterectomy also prevents complications such as consumption coagulopathy and preserves reproductive potential. Utilizing a specially developed uterine cannula, the technique of vacuum constriction involves establishing negative pressure within the uterine cavity. This method is straightforward, secure, and economically efficient. Hence, authors decided to study the response of uterine suction in intractable atonic postpartum haemorrhage cases not responding to medical management.
This was a single group cohort study carried out between January 2019 and December 2021, consisting of 50 women with atonic PPH not responding to medical management. Authors utilized vaccum retraction system to create negative pressure inside uterus. Postprocedure, amount of bloodloss is measured. The response of using uterine suction in control of intractable atonic postpartum haemorrhage is evaluated.
Out of 50 patients, 42 patients were successfully treated with uterine suction. Only eight patients required further intervention. There was a reduction in blood loss after the procedure. There was also a reduction in the need for operative procedures and hysterectomy. There is no mortality in this study.
Abnormal postpartum uterine bleeding or postpartum hemorrhage may now have a novel, quick, and efficient therapeutic option in intrauterine vacuum-induced hemorrhage management, which may also be able to reduce severe maternal morbidity and death. Before conclusively stating that this straightforward and secure method is beneficial, more randomized, controlled studies are required.
Source: Kusumam V N et al. / Indian Journal of Obstetrics and Gynecology Research 2026;13(2):288–292
