author_facet Doumouchtsis, SK
Nikolopoulos, K
Talaulikar, VS
Krishna, A
Arulkumaran, S
Doumouchtsis, SK
Nikolopoulos, K
Talaulikar, VS
Krishna, A
Arulkumaran, S
author Doumouchtsis, SK
Nikolopoulos, K
Talaulikar, VS
Krishna, A
Arulkumaran, S
spellingShingle Doumouchtsis, SK
Nikolopoulos, K
Talaulikar, VS
Krishna, A
Arulkumaran, S
BJOG: An International Journal of Obstetrics & Gynaecology
Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
Obstetrics and Gynecology
author_sort doumouchtsis, sk
spelling Doumouchtsis, SK Nikolopoulos, K Talaulikar, VS Krishna, A Arulkumaran, S 1470-0328 1471-0528 Wiley Obstetrics and Gynecology http://dx.doi.org/10.1111/1471-0528.12546 <jats:sec><jats:title>Background</jats:title><jats:p>Uterine‐sparing surgical interventions have long been practiced as an alternative to hysterectomy in the management of severe postpartum haemorrhage (<jats:styled-content style="fixed-case">PPH</jats:styled-content>); however, the risks of impairment of subsequent fertility from such procedures are unclear.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the menstrual and fertility outcomes following radiological or conservative surgical interventions for severe <jats:styled-content style="fixed-case">PPH</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Search strategy</jats:title><jats:p>A systematic review of English and non‐English articles using the Cochrane Library 2012, PubMed (1950–2012), Embase (1980–2012), and the National Research Register. The keywords used for our search included ‘fertility’, ‘reproductive outcome’, ‘postpartum haemorrhage’, ‘embolisation’, ‘hypogastric artery ligation’, ‘B‐Lynch suture’, ‘stepwise uterine devascularisation’, ‘tamponade’, and ‘uterine compression sutures’.</jats:p></jats:sec><jats:sec><jats:title>Selection criteria</jats:title><jats:p>Studies including human female subjects with at least five cases.</jats:p></jats:sec><jats:sec><jats:title>Data collection and analysis</jats:title><jats:p>Independent extraction of articles by two authors using predefined data fields, including study quality indicators.</jats:p></jats:sec><jats:sec><jats:title>Main results</jats:title><jats:p>We identified 402 publications and after exclusions, 28 studies were included in the systematic review. Seventeen studies (675 women) reported on the fertility outcomes after uterine artery embolisation, five studies (195 women) reported on the fertility outcomes after uterine devascularisation, and six studies (125 women) reported on the fertility outcomes following uterine compression sutures. Overall, 553 out of 606 (91.25%) women resumed menstruation within 6 months of delivery. One hundred and eighty‐three out of 235 (77.87%) women who desired another pregnancy achieved conception.</jats:p></jats:sec><jats:sec><jats:title>Author's conclusions</jats:title><jats:p>Uterine‐sparing radiological and surgical techniques for the management of severe <jats:styled-content style="fixed-case">PPH</jats:styled-content> do not appear to adversely affect the menstrual and fertility outcomes in most women; however, the number of studies and the quality of the available evidence is of concern.</jats:p></jats:sec> Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review BJOG: An International Journal of Obstetrics & Gynaecology
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title Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_unstemmed Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_full Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_fullStr Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_full_unstemmed Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_short Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_sort menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
topic Obstetrics and Gynecology
url http://dx.doi.org/10.1111/1471-0528.12546
publishDate 2014
physical 382-388
description <jats:sec><jats:title>Background</jats:title><jats:p>Uterine‐sparing surgical interventions have long been practiced as an alternative to hysterectomy in the management of severe postpartum haemorrhage (<jats:styled-content style="fixed-case">PPH</jats:styled-content>); however, the risks of impairment of subsequent fertility from such procedures are unclear.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the menstrual and fertility outcomes following radiological or conservative surgical interventions for severe <jats:styled-content style="fixed-case">PPH</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Search strategy</jats:title><jats:p>A systematic review of English and non‐English articles using the Cochrane Library 2012, PubMed (1950–2012), Embase (1980–2012), and the National Research Register. The keywords used for our search included ‘fertility’, ‘reproductive outcome’, ‘postpartum haemorrhage’, ‘embolisation’, ‘hypogastric artery ligation’, ‘B‐Lynch suture’, ‘stepwise uterine devascularisation’, ‘tamponade’, and ‘uterine compression sutures’.</jats:p></jats:sec><jats:sec><jats:title>Selection criteria</jats:title><jats:p>Studies including human female subjects with at least five cases.</jats:p></jats:sec><jats:sec><jats:title>Data collection and analysis</jats:title><jats:p>Independent extraction of articles by two authors using predefined data fields, including study quality indicators.</jats:p></jats:sec><jats:sec><jats:title>Main results</jats:title><jats:p>We identified 402 publications and after exclusions, 28 studies were included in the systematic review. Seventeen studies (675 women) reported on the fertility outcomes after uterine artery embolisation, five studies (195 women) reported on the fertility outcomes after uterine devascularisation, and six studies (125 women) reported on the fertility outcomes following uterine compression sutures. Overall, 553 out of 606 (91.25%) women resumed menstruation within 6 months of delivery. One hundred and eighty‐three out of 235 (77.87%) women who desired another pregnancy achieved conception.</jats:p></jats:sec><jats:sec><jats:title>Author's conclusions</jats:title><jats:p>Uterine‐sparing radiological and surgical techniques for the management of severe <jats:styled-content style="fixed-case">PPH</jats:styled-content> do not appear to adversely affect the menstrual and fertility outcomes in most women; however, the number of studies and the quality of the available evidence is of concern.</jats:p></jats:sec>
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author Doumouchtsis, SK, Nikolopoulos, K, Talaulikar, VS, Krishna, A, Arulkumaran, S
author_facet Doumouchtsis, SK, Nikolopoulos, K, Talaulikar, VS, Krishna, A, Arulkumaran, S, Doumouchtsis, SK, Nikolopoulos, K, Talaulikar, VS, Krishna, A, Arulkumaran, S
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container_title BJOG: An International Journal of Obstetrics & Gynaecology
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description <jats:sec><jats:title>Background</jats:title><jats:p>Uterine‐sparing surgical interventions have long been practiced as an alternative to hysterectomy in the management of severe postpartum haemorrhage (<jats:styled-content style="fixed-case">PPH</jats:styled-content>); however, the risks of impairment of subsequent fertility from such procedures are unclear.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the menstrual and fertility outcomes following radiological or conservative surgical interventions for severe <jats:styled-content style="fixed-case">PPH</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Search strategy</jats:title><jats:p>A systematic review of English and non‐English articles using the Cochrane Library 2012, PubMed (1950–2012), Embase (1980–2012), and the National Research Register. The keywords used for our search included ‘fertility’, ‘reproductive outcome’, ‘postpartum haemorrhage’, ‘embolisation’, ‘hypogastric artery ligation’, ‘B‐Lynch suture’, ‘stepwise uterine devascularisation’, ‘tamponade’, and ‘uterine compression sutures’.</jats:p></jats:sec><jats:sec><jats:title>Selection criteria</jats:title><jats:p>Studies including human female subjects with at least five cases.</jats:p></jats:sec><jats:sec><jats:title>Data collection and analysis</jats:title><jats:p>Independent extraction of articles by two authors using predefined data fields, including study quality indicators.</jats:p></jats:sec><jats:sec><jats:title>Main results</jats:title><jats:p>We identified 402 publications and after exclusions, 28 studies were included in the systematic review. Seventeen studies (675 women) reported on the fertility outcomes after uterine artery embolisation, five studies (195 women) reported on the fertility outcomes after uterine devascularisation, and six studies (125 women) reported on the fertility outcomes following uterine compression sutures. Overall, 553 out of 606 (91.25%) women resumed menstruation within 6 months of delivery. One hundred and eighty‐three out of 235 (77.87%) women who desired another pregnancy achieved conception.</jats:p></jats:sec><jats:sec><jats:title>Author's conclusions</jats:title><jats:p>Uterine‐sparing radiological and surgical techniques for the management of severe <jats:styled-content style="fixed-case">PPH</jats:styled-content> do not appear to adversely affect the menstrual and fertility outcomes in most women; however, the number of studies and the quality of the available evidence is of concern.</jats:p></jats:sec>
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spelling Doumouchtsis, SK Nikolopoulos, K Talaulikar, VS Krishna, A Arulkumaran, S 1470-0328 1471-0528 Wiley Obstetrics and Gynecology http://dx.doi.org/10.1111/1471-0528.12546 <jats:sec><jats:title>Background</jats:title><jats:p>Uterine‐sparing surgical interventions have long been practiced as an alternative to hysterectomy in the management of severe postpartum haemorrhage (<jats:styled-content style="fixed-case">PPH</jats:styled-content>); however, the risks of impairment of subsequent fertility from such procedures are unclear.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the menstrual and fertility outcomes following radiological or conservative surgical interventions for severe <jats:styled-content style="fixed-case">PPH</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Search strategy</jats:title><jats:p>A systematic review of English and non‐English articles using the Cochrane Library 2012, PubMed (1950–2012), Embase (1980–2012), and the National Research Register. The keywords used for our search included ‘fertility’, ‘reproductive outcome’, ‘postpartum haemorrhage’, ‘embolisation’, ‘hypogastric artery ligation’, ‘B‐Lynch suture’, ‘stepwise uterine devascularisation’, ‘tamponade’, and ‘uterine compression sutures’.</jats:p></jats:sec><jats:sec><jats:title>Selection criteria</jats:title><jats:p>Studies including human female subjects with at least five cases.</jats:p></jats:sec><jats:sec><jats:title>Data collection and analysis</jats:title><jats:p>Independent extraction of articles by two authors using predefined data fields, including study quality indicators.</jats:p></jats:sec><jats:sec><jats:title>Main results</jats:title><jats:p>We identified 402 publications and after exclusions, 28 studies were included in the systematic review. Seventeen studies (675 women) reported on the fertility outcomes after uterine artery embolisation, five studies (195 women) reported on the fertility outcomes after uterine devascularisation, and six studies (125 women) reported on the fertility outcomes following uterine compression sutures. Overall, 553 out of 606 (91.25%) women resumed menstruation within 6 months of delivery. One hundred and eighty‐three out of 235 (77.87%) women who desired another pregnancy achieved conception.</jats:p></jats:sec><jats:sec><jats:title>Author's conclusions</jats:title><jats:p>Uterine‐sparing radiological and surgical techniques for the management of severe <jats:styled-content style="fixed-case">PPH</jats:styled-content> do not appear to adversely affect the menstrual and fertility outcomes in most women; however, the number of studies and the quality of the available evidence is of concern.</jats:p></jats:sec> Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review BJOG: An International Journal of Obstetrics & Gynaecology
spellingShingle Doumouchtsis, SK, Nikolopoulos, K, Talaulikar, VS, Krishna, A, Arulkumaran, S, BJOG: An International Journal of Obstetrics & Gynaecology, Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review, Obstetrics and Gynecology
title Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_full Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_fullStr Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_full_unstemmed Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_short Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_sort menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
title_unstemmed Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review
topic Obstetrics and Gynecology
url http://dx.doi.org/10.1111/1471-0528.12546