Skip to main content
SpringerLink
Log in

Uterine packing during cesarean section in the management of intractable hemorrhage in central placenta previa

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To determine the safety and effectiveness of uterine packing in the management of intractable hemorrhage during cesarean section for central placenta previa.

Methods

This retrospective study was conducted on 70 pregnant women with central placenta previa from May 2005 to March 2010. Patients with uterine packing in the control of massive hemorrhage during cesarean section were identified. The indications, uterine packing procedures, estimated blood loss, postoperative complications, and packing material used were reviewed.

Results

A total of 70 patients were identified among 1,121 women with placenta previa during the study period. Sixty-five cases were successful in the control of intraoperative bleeding using uterine packing. Two patients with severe placenta accreta had hemorrhage during cesarean section, and packing with gauze in the uterine cavity was not able to control the bleeding, thereby resulting in cesarean hysterectomy. One case demonstrated failure in packing because of disseminated intravascular coagulation occurring before hospital admission. The remaining two patients had massive vaginal bleeding after uterine packing in cesarean section and underwent laparotomy or hysterectomy 4 h postoperative.

Conclusion

Uterine packing is a safe and effective technique in the control of intractable hemorrhage in cesarean section. It is a reasonable alternative to further surgical intervention in patients with intractable obstetric hemorrhage, especially in developing countries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. World Health Organisation (1991) Maternal mortality a global fact book. WHO, Geneva, pp 3–16

    Google Scholar 

  2. AbouZahr C (2003) Global burden of maternal death and disability. Br Med Bull 67:1–11

    Article  PubMed  Google Scholar 

  3. ACOG Practice Bulletin October 2006 (2006) Postpartum hemorrhage. Obstet Gynecol 108:1039–1046

    Google Scholar 

  4. Hsu TY (2009) Abnormal invasive placentation—placenta previa increta and percreta. Taiwan J Obstet Gynecol 48:1–2

    Article  PubMed  Google Scholar 

  5. Bakri YN, Amir A, Abdul Jabbar F (2001) Tamponade-balloon for obstetrical bleeding. Int J Gynecol Obstet 74:139–142

    Article  CAS  Google Scholar 

  6. Arduini M, Epicoco G, Clerici G, Bottaccioli E, Arena S, Affronti G (2010) B-Lynch suture intrauterine balloon and endouterine hemostatic suture for the management of postpartum hemorrhage due to placenta previa accreta. Int J Gynecol Obstet 108:191–193

    Article  Google Scholar 

  7. B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ (1997) The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol 104:372–375

    Article  PubMed  CAS  Google Scholar 

  8. Joshi V, Otiv S, Majumder R, Nikam YA, Shrivastava M (2007) Internal iliac arterial ligation for arresting postpartum haemorrhage. BJOG 114:356–361

    Article  PubMed  CAS  Google Scholar 

  9. Hunter LA (2010) Exploring the role of uterine artery embolization in the management of postpartum hemorrhage. J Perinatal Neonatal Nurs 24:207–214

    Google Scholar 

  10. Al-Harbi NA, Al-Abra ES, Alabbad NS (2009) Utero-vaginal packing. Seven years review in the management of post partum hemorrhage due to placenta previa/accreta at a maternity hospital in Central Saudi Arabia. Saudi Med J 30:243–246

    PubMed  Google Scholar 

  11. Maier RC (1993) Control of postpartum hemorrhage with uterine packing. Am J Obstet Gynecol 169:317–321 (discussion 321–323)

    PubMed  CAS  Google Scholar 

  12. Oyelese Y, Ananth CV (2010) Postpartum hemorrhage: epidemiology, risk factors, and causes. Clin Obstet Gynaecol 53:147–156

    Article  Google Scholar 

  13. Doumouchtsis S, Papageorghiou A, Arulkumaran S (2007) Systematic review of conservative management of postpartum hemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv 62:540–547

    Article  PubMed  Google Scholar 

  14. Naqvi S, Makhdoom T (2004) Conservative management of primary postpartum haemorrhage. J Coll Physicians Surg Pak 14:296–297

    PubMed  Google Scholar 

  15. Wax JR, Channell JC, Vandersloot JA (1993) Packing of the lower uterine segment—new approach to an old technique. Int J Gynecol Obstet 43:197–198

    Article  CAS  Google Scholar 

  16. Dedes I, Ziogas V (2008) Circular isthmic-cervical sutures can be an alternative method to control peripartum haemorrhage during caesarean section for placenta praevia accreta. Arch Gynecol Obstet 278:555–557

    Article  PubMed  Google Scholar 

  17. Nelson WL, O’Brien JM (2007) The uterine sandwich for persistent uterine atony: combining the B-Lynch compression suture and an intrauterine Bakri balloon. Am J Obstet Gynecol 196:9–10

    Article  Google Scholar 

  18. Cho JH, Jun HS, Lee CN (2000) Hemostatic suturing technique for uterine bleeding during cesarean delivery. Obstet Gynecol 96:129–131

    Article  PubMed  CAS  Google Scholar 

  19. Tamizian O, Arulkumaran S (2001) The surgical management of postpartum haemorrhage. Curr Opin Obstet Gynecol 13:127–131

    Article  PubMed  CAS  Google Scholar 

  20. O’Leary JA (1995) Uterine artery ligation in the control of postcaesarean haemorrhage. J Reprod Med 40:189–193

    PubMed  Google Scholar 

Download references

Conflict of interest

We declare that we have no conflicts of interest in relation to this article.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 17, Section 3, Ren Min Nan Lu, Chengdu, Sichuan, People’s Republic of China

    Junli Ge, Hua Liao, Lijun Duan, Qiang Wei & Weiyue Zeng

Authors
  1. Junli Ge
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hua Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lijun Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Qiang Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Weiyue Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Weiyue Zeng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ge, J., Liao, H., Duan, L. et al. Uterine packing during cesarean section in the management of intractable hemorrhage in central placenta previa. Arch Gynecol Obstet 285, 285–289 (2012). https://doi.org/10.1007/s00404-011-1935-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-011-1935-5

Keywords

Search

Navigation