Adhesive and Hemostatic Hydrogel for the Management of Postpartum Hemorrhage.

Postpartum hemorrhage is the number one cause of maternal mortality across the globe due to rapid and excessive blood loss. This condition frequently results from uterine atony, wherein the uterus is unable to contract itself against bleeding uterine vessels. As a result, additional management techniques are often required in order to prevent this condition from progressing to death. In this study, we present a hydrogel with hemostatic and wet tissue adhesion properties as a potential treatment for postpartum hemorrhage. This hydrogel demonstrates improved adhesivity compared to controls in lap shear and burst strength evaluations. In addition, this material demonstrates hand injectability at speeds up to 5 mL/min, good hemostatic ability in vitro, and short-term cyto- and hemocompatibility. We have evaluated this hydrogel in a rat model of uncontrolled hemorrhage and in a custom benchtop model of the postpartum uterus to contextualize these findings and to grant an understanding of this material in physiological settings. Finally, we consider potential routes of degradation and removal of the biomaterial from the uterus following successful hemorrhage control. Overall, the current hemostatic hydrogel integrates tissue adhesion, rapid hand injectability, reduced clotting time, and short-term biocompatibility, demonstrating effective bleeding control in benchtop and rat hemorrhage models.