Wendy L Nelson1, John M O'Brien. 1. Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY, USA.
Abstract
OBJECTIVE: The objective of the study was to evaluate the effectiveness of a combination of surgical interventions for control of postpartum hemorrhage. STUDY DESIGN: At cesarean delivery, patients with persistent bleeding from uterine atony after the administration of oxytonics were treated with the placement of a B-Lynch suture. When the B-Lynch failed, subsequent placement of an intrauterine Bakri balloon followed. This combination is termed the uterine sandwich. RESULTS: The uterine sandwich was successful for all 5 patients undergoing this approach. The median nadir hematocrit was 21.1% (range 20.1% to 28%). The balloon was in place for a median duration of 11 hours (range 10-24 hours). The median volume infused into the balloon was 100 mL (range 60-250 mL). No complications were observed. CONCLUSION: Placing an intrauterine Bakri balloon in conjunction with the B-Lynch uterine compression suture was successful in treating uterine atony.
OBJECTIVE: The objective of the study was to evaluate the effectiveness of a combination of surgical interventions for control of postpartum hemorrhage. STUDY DESIGN: At cesarean delivery, patients with persistent bleeding from uterine atony after the administration of oxytonics were treated with the placement of a B-Lynch suture. When the B-Lynch failed, subsequent placement of an intrauterine Bakri balloon followed. This combination is termed the uterine sandwich. RESULTS: The uterine sandwich was successful for all 5 patients undergoing this approach. The median nadir hematocrit was 21.1% (range 20.1% to 28%). The balloon was in place for a median duration of 11 hours (range 10-24 hours). The median volume infused into the balloon was 100 mL (range 60-250 mL). No complications were observed. CONCLUSION: Placing an intrauterine Bakri balloon in conjunction with the B-Lynch uterine compression suture was successful in treating uterine atony.
Authors: Dietmar Schlembach; Hanns Helmer; Wolfgang Henrich; Christian von Heymann; Franz Kainer; Wolfgang Korte; Maritta Kühnert; Heiko Lier; Holger Maul; Werner Rath; Susanne Steppat; Daniel Surbek; Jürgen Wacker Journal: Geburtshilfe Frauenheilkd Date: 2018-04-26 Impact factor: 2.915