Prospective multicenter study of the effectiveness of hemostatic Z-band with chitosan for stopping postpartum hypotonic bleeding during cesarean section

Objective. Research of clinical efficacy and safety of intrauterine application of non-woven Z-tape coated with chitosan nanofibers for stopping hypotonic uterine bleeding during caesarean section and evaluation of the possibility of its application in maternity institutions. Material and methods. During the period from 01.09.2024 to 28.02.2025 in the clinical units of the Saint Petersburg State Pediatric Medical University, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology and SPB Maternity Hospital No.17 conducted a multicenter prospective study of the effectiveness and clinical safety of the use of hemostatic Z-tape with chitosan (HZT). The prospective study included 103 patients who were delivered by caesarean section, among whom 47 (45.6%) developed intraoperative hypotonic bleeding. Results. The average amount of blood loss during surgery before the application of the hemostatic Z-tape with chitosan was — Me — 500 [Q1 — 250; Q3 — 1700] ml, the average total amount of intraoperative blood loss was — Me — 701 [Q1 — 180; Q3 — 2251] ml, and the average amount of total postpartum blood loss was — Me — 945 [Q1 — 402; Q3 — 3606] ml. The use of hemostatic Z-tape in all patients was the final method of hemostasis, and surgical hemostasis was not used. The average hemoglobin level in patients before delivery was Me — 122 [Q1 — 104; Q3 — 145] g/L. On the third day after delivery, the average hemoglobin level was Me — 107 [Q1 — 73; Q3 — 137] g/L. In the postpartum period, none of the patients required plasma transfusion and/or hemotransfusion. Conclusion. Intraoperative application of non-woven Z-tape with chitosan nanofibers is a simple, highly effective method of final stopping of hypotonic postpartum hemorrhage during caesarean section due to its hemostatic and antibacterial properties.