Uterine packing with chitosan-covered gauze compared to balloon tamponade for managing postpartum hemorrhage

Dueckelmann, A. M.; Hinkson, Larry; Nonnenmacher, A; Siedentopf, Jan-Peter; Schoenborn, Ines; Weizsaecker, Katharina; Kaufner, Lutz; Henrich, Wolfgang; Braun, Thorsten

doi:10.1016/j.ejogrb.2019.06.003

Cited by 37 publications

(25 citation statements)

References 22 publications

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“…Known risk factors for LUSA are: prolonged and precipitated delivery, polyhydramnios, fetal malpresentation or malposition (de ection of the fetal head), multiparity, low-lying placenta, VBAC, assisted reproduction, hysteroscopy, rarely LUSA may be caused by cervical and myometrial lacerations [2,3,[5][6][7][9][10][11][12][13][14][15]. In our research there were no signi cant maternal or fetal risk factors for developing LUSA, except of labor induction and labor stimulation.…”

Section: Discussionmentioning

confidence: 99%

“…In recent papers, surgical treatment of LUSA was described by means of different methods like: curettage, embolisation, vaginal packing, bilateral cervix apex clamping, transvaginal cervicouterine artery ligation, double balloon tamponade, obstruction of vascularisation by means of uterine traction towards vagina, "holding the cervix" technique, " shing for the balloon shaft" and perpendicular compressive cervical stitches and nally hysterectomy [6,9,[10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Panda et al [6] in 2009. published very appreciable paper about clinical entity known as primary LUSA that should be clearly distinguished from corporeal uterine atony.…”

Section: Discussionmentioning

confidence: 99%

“…When LUSA is the reason for PPH, conservative therapy is usually not su cient, due to the fact that there are < 10% myo brils in the region of lower uterine segment. Therefore, surgical hemostatic compressive and / or ligation management is necessary [2,3,[5][6][7][9][10][11][12][13]. Till now, the incidence of LUSA remains unknown [ (2,3,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Ultrasound examination relives empty uterine cavity, ballooned out lower uterine segment and coagulum within. According to the literature there are many suggested procedures such: manual evacuation of the coagula, curettage, different compressive methods of uterine or vaginal tamponade, uterine compression sutures and uterine artery ligation techniques as well as administration of uterotonics, anti brinolytics, tranexamic acid and peripartum hysterectomy as the last resort for the treatment of intractable severe PPH [3,6,[9][10][11][12][13][14]. The main aim of surgical methods is prevention of obstetric hemorrhagic shock complicated by disseminated intravascular coagulopathy, preservation of uterus and fertility by sustaining from hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Early Postpartum Hemorrhage Caused by Lower Uterine Segment Atony

Habek¹,

Márton

Prka

et al. 2021

Preprint

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Purpose: Lower uterine segment atony is recently being recognized as one of the major reasons for early postpartum hemorrhage.Methods: We present our experience in surgical treatment of lower uterine segment atony patients that were delivered in our tertiary perinatal center during the 10 years period (2010-2019).Results: This particular study enrolled total number of 29 543 deliveries with 215 cases of early PPH (0,72%). LUSA was diagnosed in 44 cases or in 29,93% in all uterine atony cases. Exploration of the lower uterine segment accompanied by evacuation of the coagula was conducted in 5 cases (11,36%), haemostatic ligation procedures according to authors: Losickaja in 2 cases, Hebisch-Huch in 9 cases, Habek in 5 cases, Hebisch-Huch+Losickaja in 9 cases. Evacuation procedures were combined with ligation techniques in 7 cases, evacuation methods with ligation techniques and balloon tamponade in 2 cases, exploration combined with gauze tamponade in 1 case and ligation procedures with balloon tamponade in 3 cases. According to our results, haemostatic ligation procedures alone or combined with tamponade, have shown to be highly effective in 88,63%. Conclusion: Transvaginal approach for surgical treatment of lower uterine segment atony is accessible, feasible, successful and life saving. It can be easily performed in inpatient and outpatient care settings followed by administration of uterotonics, uterostiptics and tranexamic acid and fluid replacement. All of the above mentioned methods are of great importance in the prevention and treatment of obstetric hemorrhagic shock, development of coagulopathy, multiorgan failure, postpartum hysterectomy and finally vital for fertility preservation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Treatment of Early Postpartum Hemorrhage Caused by Lower Uterine Segment Atony

Habek¹,

Márton

Prka

et al. 2021

Preprint

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“…Auch innerklinisch findet Chitosan effektiv Anwendung, z. B. bei der Behandlung von postpartalen Blutungen durch intrauterines Packing [14].…”

Section: Merkeunclassified

Prähospitale Strategien zur Minimierung des Blutverlustes

Josse¹,

Stöhr²,

Lechner³

et al. 2020

Anästhesiol Intensivmed Notfallmed Schmerzther

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ZusammenfassungDie „kritische“ Blutung ist definiert durch ihr lebensbedrohliches Ausmaß und stellt die häufigste prähospital vermeidbare Todesursache dar. Für äußere Blutungen existieren adäquate prähospitale Therapiestrategien – sie müssen aber stets in ein Gesamtkonzept entsprechend dem <C>ABCDE-Algorithmus (<C> für „critical bleeding“) eingebettet sein. In diesem Beitrag wird auf lokale manuelle Maßnahmen zur prähospitalen Blutungskontrolle fokussiert.

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PPH: Triage, Scenario, and Simulation

Bamberg

2023

Practical Guide to Simulation in Delivery Room Emergencies

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Uterine packing with chitosan-covered gauze compared to balloon tamponade for managing postpartum hemorrhage

Cited by 37 publications

References 22 publications

Surgical Treatment of Early Postpartum Hemorrhage Caused by Lower Uterine Segment Atony

Surgical Treatment of Early Postpartum Hemorrhage Caused by Lower Uterine Segment Atony

Prähospitale Strategien zur Minimierung des Blutverlustes

PPH: Triage, Scenario, and Simulation

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