The Intrauterine Pack in the Management of Postpartum Hemorrhage

Day, Lois A.; Mussey, Robert D.; DeVoe, Robert W.

doi:10.1097/00006254-194808000-00019

Cited by 4 publications

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“…In most cases of massive PPH, after ecbolics have been used and correctable causes excluded, hysterectomy or ligature of the internal iliac vessel is recommend and usually carried out 3,7 . There are a number of arguments against uterine tamponade in the manage‐ ment of postpartum haemorrhage 6 .…”

Section: Discussionmentioning

confidence: 99%

The B‐Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported

B-Lynch

Coker

Lawal

et al. 1997

BJOG

657

474

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The B-Lynch suturing technique (brace suture) may be particularly useful because of its simplicity of application, life saving potential, relative safety, and its capacity for preserving the uterus and thus fertility. Satisfactory haemostasis can be assessed immediately after application. If it fails, which has not yet been the case, other more radical surgical methods as mentioned in this paper and in the literature can be considered. The special advantage of this innovative technique is an alternative to major surgical procedures to control pelvic arterial pulse pressure or hysterectomy. This suturing technique has been successfully applied with no problems to date and no apparent complications.Postpartum haemorrhage is a serious obstetric problem. Life threatening postpartum haemorrhage can be a nightmare. Current clinical methods are unsuitable for the objective assessment of postpartum haemorrhage, and each patient's ability to compensate varies considerably. There are no reliable data on the true incidence of severe life threatening postpartum haemorrhage. The morbidity and mortality rise not only with delay in diagnosis and treatment but also in accordance with any increase in caesarean section rate. Available methods to control postpartum haemorrhage depend on the cause but in general delaying diagnosis and treatment may lead to a life threatening situation. Five percent of vaginal deliveries may lead to postpartum haemorrhage with a blood loss > 1 L3. The common causes include uterine atony, lower genital tract lacerations, retained placenta and placental fragments, coagulopathy, uterine inversion and ruptured uterus9. These causes can individually or collectively lead to life threatening situations.Published data suggest a variety of acceptable methods of treatment such as simple bi-manual compression, ecbolics such as oxytocins, syntometrine and prostaglandins which are safe and effective but occasionally prove inadequate or unsatisfactory. Surgical methods vary depending on the site of bleeding, the severity of the condition and the cardiovascular stability of the patient. Various surgical methods to reduce pelvic pulse pressure have been described, from simple surgical ligature of the uterine artery to more complicated uterine, ovarian and internal iliac artery ligature3*'. These procedures need skill which may not normally be possessed by the duty Registrar faced with such problems in the middle of the night. Probably some Consultants have never done such complicated procedures because of the relative rarity of this emergency obstetric problem.We describe an innovative method which is simple and effective, tried and tested with a successful outcome for the control of life threatening postpartum haemorrhage, as an alternative to more complicated surgery including hysterectomy. Description of techniqueThe following steps are involved in the competent application of the B-Lynch suturing technique:1. The patient under general anaesthesia is catheterised and placed in the Lloyd Davies position for acces...

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Section: Discussionmentioning

confidence: 99%

The B‐Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported

B-Lynch

Coker

Lawal

et al. 1997

BJOG

657

474

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“…The effectiveness of the IUBT lies in its mechanical compression of blood vessels against the uterine wall. The uterine tamponade technique was initially described in the early 20th century (7), but was abandoned in the 1950s based on fears that it might conceal trauma or continuous bleeding, or cause infection. Later, several cases were described in which uterine gauze tamponade was placed vaginally or via laparotomy after a cesarean procedure, with placement maintained for up to 4 days (8,9).…”

Section: Introductionmentioning

confidence: 99%

Impact of intrauterine balloon tamponade on emergency peripartum hysterectomy following vaginal delivery

Quandalle

Ghesquière

Kyheng

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Son efficacité est rapportée à hauteur de 80 à 90% selon les études, en relai d'un traitement médical premier (4,6,7). Il présente l'intérêt d'être une alternative intéressante aux traitements de seconde ligne plus invasifs, tels que les ligatures vasculaires, le capitonnage utérin, ou l'embolisation radiologique pour les centres ne disposant pas de plateau technique (6,8,9). À l'heure actuelle, il n'y a pas, à notre connaissance, de description des pratiques des professionnels concernant l'utilisation du tamponnement intra-utérin ni de description de la formation des internes à ce geste.…”

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Tamponnement intra-utérin : description des pratiques et de la formation des internes

Pouypoudat

Tomczyk

Gauchotte

et al. 2020

Gynécologie Obstétrique Fertilité & Sénologie

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The Intrauterine Pack in the Management of Postpartum Hemorrhage

Cited by 4 publications

References 0 publications

The B‐Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported

The B‐Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported

Impact of intrauterine balloon tamponade on emergency peripartum hysterectomy following vaginal delivery

Tamponnement intra-utérin : description des pratiques et de la formation des internes

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