Open AccessPRIMARY PPH;
Author(s) -
Samia Shuja,
Afia Ansar,
Nagina Fatima Liaquat
Publication year - 2008
Publication title -
the professional medical journal/the professional medical journal
Language(s) - English
Resource type - Journals
eISSN - 2071-7733
pISSN - 1024-8919
DOI - 10.29309/tpmj/2008.15.03.2845
Subject(s) - medicine , uterine atony , placenta previa , surgery , fundus (uterus) , gynecology , obstetrics , hysterectomy , placenta , pregnancy , fetus , biology , genetics
. Objective: To determine the effectiveness and safety of uterine packing in selected cases of primarypostpartum haemorrhage. Study Design: Cross-sectional study. Place and Duration: The study was conducted atJinnah Postgraduate Medical Centre, Karachi, From September 2003 to April 2008. Patients and Methods: Womendeveloping primary PPH due to uterine atony, placenta previa and coagulation failure were selected for uterine packing.Firm packing was done with enormous length of sterile ribbon gauze, using ‘layering technique’ under prophylacticantibiotic cover. Vagina was also packed to give additional pressure. Pack was removed after 12 - 36 hours or earlyin case of failure to control haemorrhage. Pulse, blood pressure, soakage of pads, height of uterine fundus andtemperature were monitored to assess effectiveness and safety. Results: 39 women were included in the study. Causeof PPH was uterine atony in 30 (76.9%), coagulation failure in 5 (12.8%) and placenta previa in 4 (10.3%) cases.Packing was successful in arresting haemorrhage in 32 (82.1%) and failed in 7 (17.9%) cases; 95% Confidence Interval67-91. There was no case of concealed haemorrhage, four patients developed emdometritis and none had delayedhaemorrhage. 13 laparotomies were prevented. The difference between the causes of haemorrhage in successful andfailed cases did not show a definite trend. Conclusion: If employed early, uterine packing is a quick, effective and safemethod for controlling primary PPH in carefully selected cases.