Uterine Packing in the Combined Management of Obstetrical Hemorrhage

Wittich, Arthur C.; Salminen, Eric R.; Hardin, E L; Desantis, Robert A.

doi:10.1093/milmed/161.3.180

Cited by 13 publications

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“…Et al, have recommended uterine packing as a pre-surgical procedure after exclusion of lacerations of lower genital tract, uterine rupture and retained placental tissue. 12 Our study also included cases of non-traumatic uterine hemorrhage and success rate of uterine packing was 90.09%. In a study by Ali et al 42 patients in whom utero-vaginal packing was done, 36 (86%) responded to the procedure; failure to achieve hemostasis occurred in 6 (14%) cases.…”

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confidence: 99%

Effectiveness of Utero-Vaginal Packing in Management of Postpartum Hemorrhage

Javed

Munir²,

Eusaph³

2017

Annals KEMU

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A major cause of maternal mortality and morbidity in developing world is post-partum hemorrhage (PPH). Different management options have been in use including use of oxytocins, prostaglandins, surgical exploration of genital tract, ligation or angiographic embolization of uterine/internal iliac arteries and hysterectomy. A simple and effective measure is to control bleeding with utero-vaginal packing which is easy and quick to perform and saves the patient need of major surgical procedures. did not respond to medical management were included in the study. Patients who had PPH due to genital tract trauma were excluded from this study. Frequencies and proportions of complications were calculated along with rate of successful cessation of bleeding. Data was analyzed by SPSS version 11. Results: 99 patients who presented with PPH were included in study.49.5% were between age of 31 -40 years, 38.4% were between 21-30 years. 8.1% of patients were P1-2, 52.5% were P3-5 and 39.4% were P6 and above. 76.7% had hemorrhage after vaginal delivery and 23.3% after lower segment caesarean section. Uterineatony was the most common cause of postpartum hemorrhage, seen in 78.78% of cases, 9.09% had placenta previa, 8.08% presented with abruption placenta and 4.04% had coagulopathy. Regarding complications 7 women had to undergo hysterectomy, fever occurred in 14.14%, 8.08% had wound infection and 2 patients died of Disseminated Intravascular Coagulation (DIC). Procedure was successful in 90.9% of cases. Conclusion: Utero-vaginal packing effectively controls postpartum hemorrhage with fewer complications and its role in emergency obstetric scan not be denied.

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confidence: 99%

Effectiveness of Utero-Vaginal Packing in Management of Postpartum Hemorrhage

Javed

Munir²,

Eusaph³

2017

Annals KEMU

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“…They described two cases managed with uterine packing. 10 In this study, incidence of hysterectomy was more in multipara patients. This is similar to study by Ozden et al where the relative increase in failure of uterine packing with increase in parity is due to deposition of collagen tissues between the muscle fi bers of uterus.…”

Section: Discussionmentioning

confidence: 50%

Uterovaginal Packing as Treatment in Primary Postpartum Hemorrhage in Patan Hospital

Pradhan

Sharma

et al. 2016

Nepal j. obstet. gynaecol.

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Aims: To study the effectiveness of uterovaginal packing in the management of primary postpartum hemorrhage (PPH).Methods: This is a retrospective study conducted in Patan hospital, Lalitpur from January 2009-2011. Patients included in the study were those with intractable hemorrhage not responding to oxytocics. Exclusion criteria included cases of PPH due to trauma. Packing was done using approximately six inches sterile gauze soaked with povidine iodine packed into the uterus from the uterine fundus up to the vaginal canal. The packing is removed after 48 hours of insertion or earlier in cases of failure to control hemorrhage.Results: There were 46 cases of uterovaginal packing for primary PPH. Uterine atony was the commonest cause of packing. Uterovaginal packing was successful in 39(84.7%) cases.Conclusion: Uterovaginal packing is safe, easy and quick procedure to manage primary PPH. It is beneficial in cases of PPH due to atony thereby conserve the uterus.

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“…In contrast, vaginal gauze packing to push the uterus upward is an effective, rapid and convenient hemostatic technique able to be carried out even with poor visualization, in places such as the emergency room. As a result, vaginal gauze packing gives the clinician a little more time to improve the patient's general status and to arrange for transfusion and further definitive treatment …”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, sudden onset of severe hemorrhage from cervical ectopic pregnancy is a time‐sensitive and challenging situation . Initial management to control acute hemorrhage, which buys some time until transfusion, surgery or an angiographic procedure, determines the prognosis of the patient …”

Section: Introductionmentioning

confidence: 99%

Angiographic findings after vaginal gauze packing: New insight into an old technique

Koyama

Maeda

Kobayashi

et al. 2013

J of Obstet and Gynaecol

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We had a transferred case of cervical ectopic pregnancy with hemorrhagic shock at 6 weeks of gestation. Upon arrival at hospital, we performed tight and full vaginal gauze packing to push the uterus upward to control the patient's hemorrhage. Following stabilization of her general condition, she was treated with uterine artery embolization. Using angiography, the effectiveness of vaginal gauze packing for emergency hemostasis by the presumed mechanism of impairing blood flow through the uterine artery was demonstrated. To our knowledge, there are no reports that have previously demonstrated angiographic findings similar to ours after vaginal gauze packing. Vaginal gauze packing is an effective, rapid, and convenient hemostatic procedure able to be carried out in a time-sensitive and challenging situation. As a result, this procedure gives clinicians more time to improve the patients' general status and arrange for transfusion and further definitive treatment.

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Uterine Packing in the Combined Management of Obstetrical Hemorrhage

Cited by 13 publications

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Effectiveness of Utero-Vaginal Packing in Management of Postpartum Hemorrhage

Effectiveness of Utero-Vaginal Packing in Management of Postpartum Hemorrhage

Uterovaginal Packing as Treatment in Primary Postpartum Hemorrhage in Patan Hospital

Angiographic findings after vaginal gauze packing: New insight into an old technique

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