CSUI – CAESAREAN SECTION: practical update on stopping the bleeding

CAESAREAN SECTION: Practical update on stopping the bleeding

This half day workshop will focus on “What doctors should do when the patient bleeds at caesarean section”. The topic is very relevant, given increasing caesarean section (CS) rates globally and in South Africa; and increasing morbidity from CS associated haemorrhage in both high and low resource settings. In addition, the SA confidential enquiry into maternal deaths has identified that bleeding associated with CS accounts for one third of haemorrhage maternal deaths both in the public and private sectors.

The workshop will have experts from Obstetrics, Gynaecology, Anaesthetics and Radiology presenting on practical aspects of management including new developments in medical management and conservative surgical measures, as well as life-saving hysterectomy and interventional radiology

The convenor has audited this topic extensively in South Africa and the contributors all have expertise in their field, including the new Head of Global surgery at UCT, Prof Salome Maswime, and two international speakers, Professor Phil Steer (Emeritus Professor from Imperial College, London) who will provide useful information on managing morbidly adherent placenta, and Prof Steve Lindow with experience in uterine artery embolization.

At the end of the workshop, the participants will have the opportunity to practice practical skills on models with the facilitators.

The programme is outlined below, subject to minor alterations.

Convenors: Professor S. Fawcus; Emeritus Professor and Senior Scholar department of Obstetrics and Gynaecology, University Cape Town; and Dr Anne Horak, Senior Specialist at Mowbray Maternity Hospital

Programme (3 hours with 10 minute tea break)

 Surgical Safety; a global look at the problem of bleeding during Caesarean section. (Professor S. Maswime FCOG, Head of global surgery, UCT) 20 mins

  1. What’s new in medications to prevent and treat PPH at CS. 15 mins.

(Prof S. Fawcus, Emeritus Professor and Senior Scholar department of Obstetrics and Gynaecology, University Cape Town and deputy chairperson of Saving Mothers committee SA)

  1. Outline of conservative surgical measures to manage PPH at CS. 20 mins (Prof Gerhard Theron, Emeritus professor and previous Head of Department Obstetrics and Gynaecology, University Stellenbosch).
  2. The morbidly adherent placenta: Overcoming the management challenges. 20 mins. (Professor Phil Steer Emeritus Professor from Imperial College, London and Emeritus Editor-in-chief, BJOG.)
  3. When, how and by whom should a Hysterectomy be done? 20 mins  (Dr T. Adams, Senior specialist and Gynaecological oncologist, Department Obstetrics and Gynaecology, University Cape Town)
  4. Can interventional radiology help with PPH at CS ? 30 mins.  (Professor Garry Sudwarts, Specialist  in Interventional radiology, University Cape Town and Prof Steve Lindow, Hull University, UK)
  5. Contribution of the anaesthetist when the patient bleeds at CS. 20 mins (Professor Rob Dyer, Senior scholar and Emeritus professor, and Dr Dominique Van Dyk, Department of anaesthesia University Cape Town, with special expertise in obstetric anaesthesia)
  6. Practical stations on conservative surgical measures for PPH at CS: 30 mins; B Lynch, artery ligations, balloon tamponade, NASG models; participants rotate between stations)