Postpartum hemorrhage refractory to uterotonics

: Postpartum hemorrhage is a major challenge in Obstetrics. It is one of the most threatened emergencies in obstetrics, a leading cause of maternal morbidity, and a primary cause of nearly a quarter of maternal deaths worldwide [Khan et al. Lancet.2006;367(9516):1066-1074]. It also represents a major public health problem globally, and significantly increases the healthcare cost worldwide.