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Clinical Obstetrics

Poster Session 4

(994) The effect of addition of intrauterine suction device to treat postpartum hemorrhage on composite morbidity

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: We sought to determine if addition of Jada, an intrauterine suction device (ISD), to a standardized algorithm for treatment of postpartum hemorrhage (PPH) as a third line option would result in improved outcomes.

Study Design: We performed a retrospective review of outcomes associated with a standard PPH clinical decision support algorithm with, and without the ISD. All women who delivered in one of 5 hospitals from a single, large healthcare system between 1/1/2022-6/1/2023 who suffered a PPH, defined as quant blood loss > 1000 cc during 24 hr. after delivery, or who received either uterine balloon tamponade (UBT) or ISD due to concern for PPH, were included. Women in the Control Group delivered between 1/1/2022-9/30/2022 when the ISD was not available while those in the Study Group delivered between 10/1/22-6/1/23 after ISD was implemented as third line therapy (1st line - pharmacologic and 2nd line - UBT as needed). The primary outcome was a maternal morbidity composite of blood transfusion, surgical/IR intervention (D&C, B-Lynch, Hysterectomy, or uterine art embolization), need for ICU admit, or massive blood loss (> 2,000 cc). Demographic and outcome data were compared using Student t-test, chi-square test and Fisher’s Exact Test as indicated.

Results: The overall rate of PPH for the control group vs. the study group was 2.1% (241 PPH/10,925 total del) vs. 3.0% (285 PPH/9,461 total del) and the rate of the primary outcome was 0.8% (161/20,238) vs. 0.92% (167/18,034) respectively. Maternal demographic information and outcomes are in Table 1. There was no significant difference in the rate of the primary composite outcome after implementation of the ISD in the study group compared to the control group [106 cases/9,461 del (1.1%) vs. 95 cases/10,925 del (0.87%); p=0.6].

Conclusion: Introduction of the ISD as a third line of treatment for PPH was not associated with a reduction of the composite morbidity of PPH.