J Reprod Med
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Case Reports
Gelatin-thrombin hemostatic matrix in the management of placental site postpartum hemorrhage: a case report.
Gelatin-thrombin matrix (FloSeal, Baxter Healthcare Corporation, Fremont, California), a biodegradable hemostatic sealant, has been shown to control bleeding in multiple intraoperative scenarios and surgical disciplines. However, limited data is available regarding its use in obstetrics. A case of placental-site obstetric hemorrhage controlled with gelatin-thrombin matrix at time of cesarean delivery is presented. ⋯ Abnormal placentation is a predisposing factor of postpartum hemorrhage. In the absence of placenta accreta, profuse hemorrhage can occur from large vascular sinuses associated with a denuded implantation site in the poorly contractile lower uterine segment. In the event of unsuccessful hemorrhage control with conservative techniques, emergency hysterectomy is performed as a life-saving procedure. Multiple unit blood transfusion is often encountered. In the case presented, the use of gelatin-thrombin matrix gel for placental site hemorrhage management at the time of cesarean delivery resulted in rapid control of hemorrhage, uterine preservation and avoidance of massive blood transfusion.