Use of Hemostatic Gel in Postpartum Hemorrhage Due to Placenta Previa

BACKGROUND: Hemostasis for placenta previa is notoriously difficult because of the poor contractility of the lower segment. A hemostatic gel offers a new type of hemostatic matrix, which may have advantages. CASE: A 35-year-old woman had a postpartum hemorrhage despite the use of uterotonics 2 hours after cesarean delivery for major placenta previa. On relaparotomy, heavy oozing from the placental site was found. Difficult accessibility and profuse bleeding prompted the consideration of alternative treatment with the topical application of hemostatic gel over the lower segment, which achieved hemostasis within minutes. CONCLUSION: Hemostatic gel is easily applicable and provides quick and effective hemostatic control in the lower segment, where surgical intervention may be difficult. (Obstet Gynecol 2010;116:528-30)