Ukrainian Journal of Perinatology and Pediatrics. 2025.3(103): 37-43. doi: 10.15574/PP.2025.3(103).3743
Govsieiev D. O., Akhrameyev S. I.
Perinatal Center of Kyiv, Ukraine

For citation: Govsieiev DO, Akhrameyev SI. (2025). Comparison of approaches to the treatment of postpartum hemorrhage in women after repeat cesarean section. Ukrainian Journal of Perinatology and Pediatrics. 3(103): 37-43. doi: 10.15574/PP.2025.3(103).3743.
Article received: Jun 13, 2025. Accepted for publication: Sep 15, 2025.

The need to reduce maternal mortality and complications associated with postpartum hemorrhage remains relevant today.
Aim – to study the effectiveness of modern methods of prevention and treatment of postpartum hemorrhage in women after repeated cesarean section, including surgical, medical, and combined approaches.
Materials and methods. The study was performed as a retrospective analysis of clinical cases of women with repeated cesarean section in 2019-2024 in specialized institutions of Ukraine. The sample included 200 patients aged 25-40 years, divided into four groups depending on the applied prophylaxis and treatment. The analysis was carried out according to medical histories, taking into account the volume of blood loss (determined by the gravimetric method). Statistical processing of the results was performed using the methods of analysis of variance.
Results. The study showed that the average blood loss was the greatest in patients treated with the combined approach (standard prophylaxis + extended prophylaxis + remodeling of the lower uterine segment + compression sutures according to Bilinch) and the lowest in patients treated with the combined approach; these patients were characterized by the shortest duration of hospitalization (5.8±1.2 days) and the lowest need for additional medications (15.0%). The obtained data confirm the effectiveness of comprehensive prophylaxis in reducing blood loss and improving postoperative recovery.
Conclusions. The effectiveness of preventing postpartum hemorrhage in women after repeated cesarean section directly depends on the tactics used. The best indicators – the least blood loss, lower need for blood transfusion, shorter postoperative period and faster recovery – were recorded in patients who used only the combined approach. The results obtained indicate that this technique is the most optimal and appropriate for preventing bleeding in women with repeated cesarean section and can serve as the basis for improving clinical protocols.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the institution’s Local Ethics Committee. The informed consent was obtained from patients.
The authors declare no conflict of interest.
Keywords: postpartum hemorrhage, cesarean section, prophylaxis, hemostasis, obstetric complications.

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