Surgical remedies for postpartum hemorrhage.

When medical therapy is unsuccessful, surgical approaches to postpartum hemorrhage are often considered. These may include uterine curettage, laceration repair, balloon tamponade, compressive suture techniques, uterine or hypogastric artery ligation, and ultimately hysterectomy. A systems approach to the care of these patients includes identification of rapid response teams, assessment of risk factors, and the timely and knowledgeable use of blood and blood products. Comprehensive care of patients with massive obstetric hemorrhage will improve the outcome of this largely preventable cause of maternal mortality.