Case Report: Uterovaginal Packing with Rolled Gauze in Postpartum Hemorrhage
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- Category: Vol. 77, June 2009
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Case Report: Uterovaginal Packing with Rolled Gauze in Postpartum Hemorrhage,MOHAMAD A.S. AHMAD, MOHAMAD EL TAHER and TAMER EL KADIE
Abstract
Management options for postpartum hemorrhage (PPH) include oxytocics, prostaglandins, genital tract exploration, ligation or angiographic embolization of uterine/internal iliac arteries and hysterectomy. After excluding uterine rupture, genital tract lacerations and retained placental tissue, efforts are directed toward contracting the uterus by bimanual com-pression and oxytocics. If these are not successful, one must resort to surgical techniques. At this stage, an alternative option to remember is uterovaginal packing. Easy and quick to perform, it may be used to control bleeding by tamponade effect and stabilize the patient until a surgical procedure is arranged. Uterovaginal packing may sometimes obviate the need for surgery altogether. Two cases, a primary and a secondary PPH, managed recently with uterovaginal packing are reported. Despite concerns about concealed hemorrhage or the development of infection with this intervention, none of these problems were encountered and uterine packing was successful even in the case of secondary PPH with documented infection.