Review and analytical analysis of current trends in improving preventive and therapeutic measures for postpartum hemorrhage in women with repeat cesarean sections

Abstract

DOI: 10.52705/2788-6190-2025-02.1-02
УДК 616.33-002.5-085.6:618.74

Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality, particularly among women undergoing repeat cesarean sections. With the increasing rate of surgical deliveries in modern obstetrics, the study of effective preventive and therapeutic strategies for PPH has become highly relevant.
The objective: to analyze current trends in improving preventive and therapeutic measures for postpartum hemorrhage in women with repeat cesarean sections and to assess the effectiveness of innovative approaches to its prevention and treatment.
Materials and methods. A systematic review of scientific literature, clinical studies, and medical guidelines published between 2020 and 2025 was conducted using databases such as Scopus, PubMed, Web of Science, Google Scholar, and Ukrainian medical sources. The study evaluated the effectiveness of modern pharmacological, surgical, and innovative methods, including the use of carbetocin, tranexamic acid, uterine compression sutures, balloon tamponade, REBOA, predictive algorithms, and personalized approaches.
Results. The use of carbetocin reduced average blood loss by 180 mL compared to oxytocin, while combined therapy (misoprostol + oxytocin) reduced hemorrhage by 35%. Surgical innovations such as the “knapsack” uterine suture technique and vacuum tamponade showed over 90% effectiveness in PPH prevention. Predictive models and AI-based systems increased the accuracy of identifying hemorrhage risk to 88–95%.
Conclusions. A comprehensive approach that integrates pharmacological treatment, organpreserving surgical techniques, innovative predictive models, and personalized patient management strategies significantly reduces the incidence of postpartum complications and improves the quality of obstetric care for women undergoing repeat cesarean deliveries.