{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:26:47Z","timestamp":1789187207153,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the feasibility and preliminary clinical efficacy of the abdominal aortic tourniquet as a temporary intervention for managing severe postpartum hemorrhage (PPH) resulting from uterine atony in a war\u2010affected region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, open\u2010label, non\u2010randomized, proof\u2010of\u2010concept study was performed at Olexandrivska Hospital, Zaporizhzhia, Ukraine from December 2024 to April 2025. Four women (\u226518\u2009years) with primary PPH (&gt;1000\u2009mL blood loss) unresponsive to standard management (uterotonics, balloon tamponade) were included. The abdominal aortic tourniquet was applied, achieving temporary aortic occlusion by inflating it to 250\u2009mm Hg pressure for a duration of up to 45\u2009min. Clinical outcomes, feasibility, and safety parameters were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In all cases, external bleeding was effectively controlled within 2\u2009min of tourniquet inflation. This provided critical time for mobilizing the surgical team, preparing the operating theater, administering anesthesia, and delivering blood products. The device remained in place during a mean period of 38.8\u2009min (range 30\u201345\u2009min). After achieving adequate anesthesia and availability of resources, the device was deflated under observation. In three patients (75%), bleeding resumed upon release of the aortic compression, prompting immediate surgical intervention. In one patient (25%), bleeding ceased spontaneously after deflation without further intervention. No device\u2010related complications, thrombotic events, infections, or ischemic injuries were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The abdominal aortic tourniquet was effective in temporarily controlling severe PPH in a conflict\u2010affected, resource\u2010limited setting. By safely bridging the critical time gap before definitive surgical management, this life\u2010saving intervention demonstrated considerable potential for use in resource\u2010limited and crisis settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70395","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T13:02:33Z","timestamp":1752843753000},"page":"582-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Temporary aortic occlusion with the abdominal tourniquet for refractory postpartum hemorrhage: A proof\u2010of\u2010concept study in a war\u2010affected region"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1257-1543","authenticated-orcid":false,"given":"Yevheniia","family":"Poliakova","sequence":"first","affiliation":[{"name":"Olexandrivska Hospital  Zaporizhzhia Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8334-3022","authenticated-orcid":false,"given":"Viktor","family":"Oshovskyy","sequence":"additional","affiliation":[{"name":"Uniklinika Medical Centre  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000869"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001473"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-2018-000953"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/S13031-025-00644-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.02.040"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X19005235"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X9402200512"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.09.017"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14116"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2021.1875446"},{"key":"e_1_2_8_13_1","unstructured":"Abdominal Aortic and Junctional Tourniquet\u2014Stabilized\u2014AAJT\u2010S North American Rescue. Accessed May 4 2025.https:\/\/www.narescue.com\/abdominal\u2010aortic\u2010and\u2010junctional\u2010tourniquet\u2010stablized\u2010aajt\u2010s.html"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002231"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002346"},{"key":"e_1_2_8_16_1","first-page":"41","volume-title":"WHO recommendations for the prevention and treatment of postpartum haemorrhage","author":"Department of Reproductive Health and Research W","year":"2012"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2022.04.042"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2008.00975.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1447-0756.2011.01574.X"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70395","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70395","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T07:39:52Z","timestamp":1771313992000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/ijgo.70395"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70395","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,18]]},"assertion":[{"value":"2025-05-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}