Application of Uterine Compression Suture in Association With Intrauterine Balloon Tamponade (“Uterine Sandwich”) for Postpartum Hemorrhage

Yoong, Wai; Ridout, Alexandra; Memtsa, Maria; Stavroulis, A.; Aref-Adib, M.; Ramsay-Marcelle, Zeudi; Fakokunde, A.

doi:10.1097/01.aoa.0000422735.87489.5b

Cited by 23 publications

(38 citation statements)

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“…For example the Bakri B-Lynch sandwich technique. [61][62][63] However, there are no comparative studies in which the reverse order is considered, whereby a balloon is used first and if unsuccessful, using a compression suture or vascular ligation.…”

Section: Discussionmentioning

confidence: 99%

A review of current practice in using Balloon Tamponade Technology in the management of postpartum haemorrhage

Georgiou

2014

Hypertens Res Pregnancy

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The use of various Balloon tamponade technologies has steadily increased over the last five years in the management of postpartum haemorrhage. New methodologies and applications have been included beyond the original descriptions. Furthermore, novel approaches and mechanisms of action have also been suggested. No comparative trials involving "uterine/fertility sparing" approaches such as Balloon Tamponade Technology have been performed comparing the safety, efficiency and long term effects on endometrial and myometrial functions. However, balloon tamponade technology is rapidly becoming accepted as a preferred second line approach following failed first line uterotonics in many obstetric units. This paper reviews the current use of various balloon tamponade technologies in the management of postpartum haemorrhage.

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Section: Discussionmentioning

confidence: 99%

A review of current practice in using Balloon Tamponade Technology in the management of postpartum haemorrhage

Georgiou

2014

Hypertens Res Pregnancy

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“…In combination techniques such as the ' sandwich ' , the insuffl ation volume of the balloon may be important and authors (Yoong et al 2011) have suggested observing for signs of ' uterine blanching ' as a subjective measure of the balloon achieving its tamponade eff ect. Although the manufacturer recommends 500 ml as the upper limit for Bakri balloon insuffl ation when used in isolation, the correct tamponade volume in the ' uterine sandwich ' combination remains an area which warrants Uterine necrosis 31 technique.…”

Section: Discussionmentioning

confidence: 99%

Uterine necrosis following application of combined uterine compression suture with intrauterine balloon tamponade

Lodhi

Golara

Karangaokar

et al. 2011

Journal of Obstetrics and Gynaecology

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“…4 Since in low resource settings Bakri balloon is not available, we have used Foley's catheter (which is universally available), as a means of internal uterine tamponade.…”

Section: -3mentioning

confidence: 99%

“…4 Various variations of techniques have been tried since PPH results in significant maternal morbidity and mortality. 5 The principal indications for this procedure are patients with an atonic uterus, unresponsive to the aggressive conservative management after caesarean section or vaginal delivery, who are haemodynamically stable and who desires future reproductive capability.…”

Section: -3mentioning

confidence: 99%

“…[1][2][3] Combination technique of external compression incorporating the UCS and internal uterine tamponade (uterine sandwich) using a Bakri balloon has been employed which applies forces to both the external as well as the internal surfaces of the myometrium. 4 Since in low resource settings Bakri balloon is not available, we have used Foley's catheter (which is universally available), as a means of internal uterine tamponade. 5 Since PPH results in significant maternal morbidity and mortality and at times in face of PPH refractory to medical management and gynaecologists in general have a poor or no exposure to internal iliac artery ligation and sometimes even after stepwise devascularisation when some degree of bleeding is present and the patient and relatives are adamant about preserving the uterus and future fertility especially in our country where the quest of a male child is paramount, a sandwich technique (after proper counselling regarding pro and cons ) can be useful as a uterine conserving and fertility preserving surgery.…”

Section: Introductionmentioning

confidence: 99%

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Use of combination method (uterine sandwich technique) to control postpartum hemorrhage

Dhillon

2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONGlobally uterine atony is one of the commonest form of PPH and results in significant maternal mortality and morbidity.As one of the quick, effective and safe interventions for control of PPH, uterine compression sutures(UCS) were introduced by Christopher B Lynch. Since then many modifications of UCS has been practised. 1-3Combination technique of external compression incorporating the UCS and internal uterine tamponade (uterine sandwich) using a Bakri balloon has been employed which applies forces to both the external as well as the internal surfaces of the myometrium. 4 Since in low resource settings Bakri balloon is not available, we have used Foley's catheter (which is universally available), as a means of internal uterine tamponade. 5Since PPH results in significant maternal morbidity and mortality and at times in face of PPH refractory to ABSTRACT Background: Uterine atony is the most common cause (75%-90%) of primary postpartum hemorrhage (PPH) and Christopher B Lynch was the first to highlight the use of Uterine Compression Sutures (UCS) for the management of atonic PPH. In combination therapy, the (UCS) is combined with intrauterine balloon tamponade, known as (uterine sandwich), for combined external as well as internal compression for more effective hemostatic control of uterine bleeding. Methods: The uterine sandwich technique was used in a total of twelve patients managed in a tertiary care service hospital during caesarean deliveries. In four cases of uterine atony, the sandwich technique was used, for patients unresponsive to the conservative management. In eight patients the sandwich technique was used as a prophylactic measure, where according to the clinical profile of the patient there was high risk of PPH and where either blood was not available or availability was limited. Results: In the four cases of uterine atony, the uterine sandwich technique was used therapeutically. All the patients were multigravidae. The period of gestation ranged from 34 weeks to 37 weeks. Average operating time was 50-60 mts, average estimated blood loss was 1600 ml, average distension of Foleys catheter was 90 ml and average duration of the intrauterine Foleys catheter balloon being in situ was 12 hrs. In eight patients, the sandwich technique was used as a prophylactic measure, for varied indications. In all the cases there was successful outcome. Post-operative outcome was uneventful in all the cases. Conclusions: The uterine sandwich technique can be used either prophylactically or therapeutically for control of PPH. It is simple, safe, easy, effective and is easier to perform than internal iliac artery ligation and should be considered prior to proceeding for hysterectomy in a hemodynamically stable patient, in whom uterine conservation or fertility preservation is essential.

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Application of Uterine Compression Suture in Association With Intrauterine Balloon Tamponade (“Uterine Sandwich”) for Postpartum Hemorrhage

Cited by 23 publications

References 0 publications

A review of current practice in using Balloon Tamponade Technology in the management of postpartum haemorrhage

A review of current practice in using Balloon Tamponade Technology in the management of postpartum haemorrhage

Uterine necrosis following application of combined uterine compression suture with intrauterine balloon tamponade

Use of combination method (uterine sandwich technique) to control postpartum hemorrhage

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