Title: Role of Uterine Packing in Control of Postpartum Haemorrhage in Modern Obstetrics
Author: Dr Renu Jain
DOI: https://dx.doi.org/10.18535/jmscr/v6i8.30
Abstract
Background: Postpartum haemorrhage is the leading cause of maternal mortality in most low income countries. One of the earliest methods of achieving a tamponade effect on uterus to control PPH was by uterine packing. The objective of present study was to evaluate the safety and effectiveness of uterine packing in treatment of postpartum hemorrhage, refractory to medical treatment.
Material and Methods: The retrospective analysis of 50 cases of PPH, treated with uterine packing as a conservative therapeutic option, was done in department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior (M.P.).
Results: The uterine packing was successful in controlling PPH in 94% cases. It was effective in 96.96% (32 out of 33) women with uterine atony, who did not respond to uterotonic drugs. It was also effective in 11cases of placental implantation site bleeding, and 3 cases of deranged coagulation function. In 3 cases it failed to control PPH and peripartum hysterectomy was done. The uterine pack was removed in 24-48 hours. 3 cases of febrile morbidity and 3 cases of caesarean section wound infection were noted. There was no maternal death.
Conclusion: Uterine packing is a safe, quick and effective, conservative procedure for the control of postpartum haemorrhage, which shortens the hospital stay and avoids the need for more aggressive procedures.
Keywords: Maternal mortality, postpartum hemorrhage (PPH), peripartum hysterectomy.
