Open AccessApplication of uterine compression suture in association with intrauterine balloon tamponade (‘uterine sandwich’) for postpartum hemorrhage
Author(s) -
YOONG WAI,
RIDOUT ALEXANDRA,
MEMTSA MARIA,
STAVROULIS ANDREAS,
AREFADIB MERNOOSH,
RAMSAYMARCELLE ZEUDI,
FAKOKUNDE ABIODUN
Publication year - 2012
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2011.01153.x
Subject(s) - medicine , uterine atony , placenta previa , balloon tamponade , tamponade , hysterectomy , balloon , surgery , fibrous joint , pregnancy , obstetrics , uterus , placenta , fetus , biology , genetics
We evaluated in a prospective observational study the use of a ‘uterine sandwich’ technique (uterine compression sutures in association with intrauterine tamponade) in women who had had unsuccessful medical treatment for postpartum hemorrhage. Ten of the 11 patients had cesarean sections (complicated by placenta previa and uterine atony) and one had a normal delivery. The median estimated blood loss and units of blood transfused were 1500ml (range 750–4000ml) and two units (range 0–9), respectively. B‐Lynch sutures were placed in two patients and Hayman's modification was used in nine. Bakri balloon tamponade was in place for a median of 22hours (range 17–27hours), while the median volume infused in the balloon was 300ml (range 150–350ml). The combined technique was successful in avoiding hysterectomy in all cases, and there was no documented postpartum morbidity. This is a simple and quick surgical technique that can be used to treat atonic postpartum hemorrhage, particularly in conjunction with placenta previa.