Application of uterine compression suture in association with intrauterine balloon tamponade ('uterine sandwich') for postpartum hemorrhage

Wai Yoong, Alexandra Ridout, Maria Memtsa, Andreas Stavroulis, Mernoosh Aref-Adib, Zeudi Ramsay-Marcelle, Abiodun Fakokunde

Research output: Contribution to journalReview articlepeer-review

38 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)147-151
Number of pages5
JournalActa Obstetricia et Gynecologica Scandinavica
Volume91
Issue number1
DOIs
Publication statusPublished - Jan 2012

Keywords

  • Bakri balloon
  • Hayman suture
  • postpartum hemorrhage
  • uterine compression suture
  • uterine sandwich

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