Use of intrauterine application of chitosan-coated tape in the management of postpartum hemorrhage
Ivanov D.O., Rukhliada N.N., Mikhailov A.V., Rossolko D.S., Libova T.A., Reznik V.A., Prokhorovich T.I., Taits A.N., Khamidov V.A., Kurdynko L.V., Kuznetsov A.A.
Reducing maternal mortality remains a priority in the field of medicine. Hypotonic bleeding is a common and preventable cause of maternal death, highlighting the need for improved techniques to achieve hemostasis in such cases.
Objective: To evaluate the outcomes of intrauterine application of chitosan-coated tape for treating postpartum hemorrhage.
Materials and methods: From November 2024 to February 2025, 21 patients were treated at the Perinatal Center of St. Petersburg State Pediatric Medical University for postpartum hemorrhage resistant to uterotonic therapy, with blood loss exceeding 500 mL after vaginal delivery or more than 1000 mL during a cesarean section. In the four patients who delivered vaginally, a hemostatic chitosan-coated tape was applied to the uterine cavity through the cervical canal. For the 17 patients who underwent cesarean section, the distal end of the tape was inserted through the uterine incision into the cavity up to the fundus, while the proximal end was brought out through the cervical canal and vagina using a clamp. The hemostatic chitosan-coated tape was removed after 18–24 hours using ultrasound guidance.
Results: Complete cessation of bleeding was achieved in all patients who received the intrauterine application of the hemostatic chitosan-coated tape, eliminating the need for invasive procedures such as hemostatic sutures, arterial ligation, or hysterectomy, and avoiding blood transfusion. Blood loss during hypotonic postpartum hemorrhage after vaginal delivery ranged from 650 to 1700 mL, whereas blood loss during exposure to the hemostatic chitosan-coated tape ranged from 50 to 200 mL, resulting in a total blood loss between 700 and 1750 mL. In cesarean sections, blood loss from hypotonic postpartum hemorrhage ranged from 1090 to 1400 mL, with exposure to the hemostatic tape resulting in blood loss of 50 to 100 mL, leading to a total blood loss between 1240 and 1700 mL.
Conclusion: Intrauterine application of hemostatic chitosan-coated tape is an effective method for managing postpartum hemorrhage caused by uterine atony. The rapid achievement of hemostasis helped prevent massive blood loss and the need for transfusions, representing a significant advantage of this technique over other techniques.
Authors' contributions: Ivanov D.O., Rukhliada N.N. – conception and design of the study; Mikhailov A.V., Prokhorovich T.I. – editing of the manuscript; Rossolko D.S. – drafting of the manuscript; Libova T.A. – statistical analysis; Reznik V.A., Taits A.N., Khamidov V.A., Kurdynko L.V., Kuznetsov A.A. – material collection and processing.
Conflicts of interest: The authors have no conflicts of interest and commercial interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the St. Petersburg State Pediatric Medical University.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Ivanov D.O., Rukhliada N.N., Mikhailov A.V., Rossolko D.S., Libova T.A., Reznik V.A., Prokhorovich T.I., Taits A.N., Khamidov V.A., Kurdynko L.V., Kuznetsov A.A. Use of intrauterine application
of chitosan-coated tape in the management of postpartum hemorrhage.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (1): 39-44 (in Russian)
https://dx.doi.org/10.18565/aig.2025.310
Keywords
hypotonic hemorrhage
maternal mortality
hemostatic chitosan-coated tape
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Received 28.10.2025
Accepted 28.11.2025
About the Authors
Dmitry O. Ivanov, Professor, Dr. Med. Sci., Rector, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, 194000, Russia, St. Petersburg,Litovskaya str., 2; Chief Neonatologist of the Ministry of Health of Russia.
Nikolai N. Rukhliada, Professor, Dr. Med. Sci., Head of the Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, 194000, Russia, St. Petersburg, Litovskaya str., 2.
Anton V. Mikhailov, Honored Doctor of the Russian Federation, Professor, Dr. Med. Sci., Chief Physician, Maternity Hospital No. 17; Chief Researcher, D.O. Ott Research Institute of Obstetrics and Gynecology and Reproductology; Professor, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, and
Academician I..P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia.
Dmitry S. Rossolko, PhD, Associate Professor, Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, 194000, Russia, St. Petersburg, Litovskaya str., 2, +7(905)200-33-52, drossolko@mail.ru
Tatyana A. Libova, PhD, Associate Professor, Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of, 194000, Russia, St. Petersburg, Litovskaya str., 2.
Vitaly A. Reznik, Dr. Med. Sci., Chief Physician, Clinic of St. Petersburg State Pediatric Medical University; Associate Professor, Department of Neonatology, Perinatology and Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, 194000, Russia, St. Petersburg, Litovskaya str., 2.
Tatyana I. Prokhorovich, PhD, Associate Professor, Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, 194000, Russia, St. Petersburg, Litovskaya str., 2.
Anna N. Taits, PhD, Deputy Chief Physician for Medical Affairs, Perinatal Center of St. Petersburg State Pediatric Medical University; Associate Professor, Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, 194000, Russia, St. Petersburg, Litovskaya str., 2.
Vadim A. Khamidov, doctor of the highest category, Head of the Maternity Ward, Perinatal Center of St. Petersburg State Pediatric Medical University.
Lyudmila V. Kurdynko, doctor of the highest category, Head of the Postpartum Department, Perinatal Center of St. Petersburg State Pediatric Medical University.
Alexander A. Kuznetsov, PhD, obstetrician-gynecologist, Maternity Hospital No. 17; Teaching Assistant, Academician I..P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia.
Corresponding author: Dmitry S. Rossolko, drossolko@mail.ru
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