Packing of uterus at cesarean section for refractory post - partum hemorrhage

2000 ◽  
Vol 70 ◽  
pp. A21-A21
Author(s):  
M. Gandhi
Keyword(s):  
Cesarean Section ◽  
Post Partum ◽  
Post Partum Hemorrhage

Balloon tamponade during cesarean section is useful for severe post-partum hemorrhage due to placenta previa

2011 ◽  
Vol 38 (1) ◽  
pp. 102-107 ◽  
Author(s):  
Takako Ishii ◽  
Kenjiro Sawada ◽  
Shunsuke Koyama ◽  
Aki Isobe ◽  
Atsuko Wakabayashi ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Post Partum ◽  
Post Partum Hemorrhage ◽  
Balloon Tamponade

scholarly journals Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: A systematic review and metanalysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252491
Author(s):  
Maria Regina Torloni ◽  
Monica Siaulys ◽  
Rachel Riera ◽  
Ana Luiza Cabrera Martimbianco ◽  
Rafael Leite Pacheco ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Cesarean Section ◽  
Post Partum ◽  
Average Risk ◽  
Limited Evidence ◽  
Post Partum Hemorrhage ◽  
Uterine Incision ◽  
Mean Differences ◽  
Calculated Average

Background There is no consensus on the best timing for prophylactic oxytocin administration during cesarean section (CS) to prevent post-partum hemorrhage (PPH). Objectives Assess the effects of administrating prophylactic oxytocin at different times during CS. Methods We searched nine databases to identify relevant randomized controlled trials (RCT). We pooled results and calculated average risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI). We used GRADE to assess the overall evidence certainty. Results We screened 13,389 references and included four trials. We found no statistically significant differences between oxytocin given before versus after fetal delivery on PPH (RR 0.60, 95%CI 0.15–2.47; 1 RCT, N = 300) or nausea/vomiting (RR 1.21, 95%CI 0.69–2.13; 1 RCT, N = 300). There was a significant reduction in the need for additional uterotonics when oxytocin was given immediately before uterine incision versus after fetal delivery (RR 0.37, 95%CI 0.18–0.73; I2 = 0%; 2 RCTs; N = 301). Oxytocin given before fetal delivery significantly reduced intra-operative blood loss (MD -146.77mL, 95%CI -168.10 to -125.43; I2 = 0%; 3 RCTs, N = 601) but did not change the incidence of blood transfusion (RR 0.50, 95%CI 0.13–1.95; I2 = 0%; 2 RCTs, N = 301) or hysterectomy (RR 3.00; 95%CI 0.12–72.77; I2 = 0%; 2 RCTs, N = 301). One trial (N = 100) compared prophylactic oxytocin before versus after placental separation and found no significant differences on PPH, additional uterotonics, or nausea/vomiting. Conclusions In women having pre-labor CS, there is limited evidence indicating no significant differences between prophylactic oxytocin given before versus after fetal delivery on PPH, nausea/vomiting, blood transfusion, or hysterectomy. Earlier oxytocin administration may reduce the volume of blood loss and need for additional uterotonics. There is very limited evidence suggesting no significant differences between prophylactic oxytocin given before versus after placental separation on PPH, need for additional uterotonic, or nausea/vomiting. The overall certainty of the evidence was mostly low or very low due to imprecision. Protocol: CRD42020186797.

scholarly journals A randomized controlled trial of sublingual Misoprostol - 600µg versus intravenous Oxytocin - 10IU in prevention of post partum hemorrhage during cesarean section

2019 ◽  
Vol 8 (10) ◽  
pp. 3865 ◽  
Author(s):  
Rajasri G. Yaliwal ◽  
Shailaja R. Bidri ◽  
Ashwini S. Navani
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Late Onset ◽  
Post Partum ◽  
Common Side Effect ◽  
Suitable Alternative ◽  
Post Partum Hemorrhage ◽  
Emergency Cesarean ◽  
Estimated Blood Loss ◽  
Sublingual Misoprostol

Background: Mortality related to pregnancy and childbirth causes half a million women around the world to die annually. About 35% of these deaths are from postpartum hemorrhage (PPH). Prevention of PPH has been advised by the WHO by the use of Oxytocin 10 IU IM or IV and Misoprostol 600 µg in low resource settings in vaginal delivery. However there have been only a few reports on the use of Misoprostol during cesarean section. The best route and dose of Misoprostol is still being debated.Methods: One hundred women with term singleton pregnancy undergoing elective or emergency cesarean section under spinal anesthesia were randomly allocated to receive either Misoprostol 600µg sublingually or intravenous oxytocin 10 IU soon after delivery of the baby. Estimated blood loss and comparative change in preoperative hemoglobin to post operative hemoglobin levels and side effects were evaluated.Results: Blood loss was found to be more in Misoprostol than Oxytocin. Eight patients of the Misoprostol group required additional oxytocics. Oxytocin group did not receive any additional drugs. No surgical intervention was made in either of the groups.  The most common side effect with Misoprostol was shivering (46%) and in Oxytocin group fever (4%).Conclusions: Sublingual Misoprostol of 600µg works to prevent postpartum bleeding. In our study Oxytocin was more effective than Misoprostol in preventing PPH during cesarean section. Late onset of action of Misoprostol in comparison to Oxytocin may render suturing of the uterus difficult due to pooling of blood. In settings in which use of Oxytocin is not feasible, Misoprostol might be a suitable alternative for post-partum hemorrhage.

scholarly journals Intrauterine Gauze Packing in Primary Post Partum Hemorrhage following Caesarean section: A Clinical study

2013 ◽  
Vol 7 (1) ◽  
pp. 33-36
Author(s):  
Shao Yong ◽  
M Pradhan
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Placenta Previa ◽  
Post Partum ◽  
Cost Effective ◽  
Invasive Technique ◽  
Safe Procedure ◽  
Post Partum Hemorrhage ◽  
Gauze Packing ◽  
A Prospective Study

Aims: To study the effectiveness of uterine gauze packing to manage and prevent primary postpartum haemorrhage during cesarean delivery. Methods: This was a prospective study that was conducted in the department of obstetrics and gynecology, first affiliated hospital of Chongqing Medical University from Jan to May 2011. Patients included in the study were those with intractable postpartum hemorrhage not responding to medical treatment and for prevention of hemorrhage that could develop during cesarean section. Exclusion criteria included cases of ruptured uterus and vaginal deliveries.Packing was done using 2 m long and 10 cm wide sterilized gauze from the fundus through the cesarean incision with its end passing through cervix into the vagina and left for 24-48 hours or removed earlier in cases of failure to control hemorrhage. Results: Intrauterine gauze packing during cesarean section to arrest primary postpartum hamorrhage is a successful non-invasive technique. Intractable primary postpartum hamorrhage encountered in 42 (30.9%) cases had PPH after cesarean section. Placenta previa found in 48 (35.3%) cases unresponsive to uterotonics drugs was the commonest cause of uterine gauze packing. Intrauterine gauze packing was successful in 130 (95.6%) cases. Conclusions: Uterine packing is a cost effective, quick and safe procedure to manage and prevent primary PPH during cesarean delivery. Uterine packing is of benefit in achieving hemostasis particularly in cases of post partum hemorrhage due to low-lying placenta previa/accreta associated with lower segment bleeding conserving the uterus in women with cesarean delivery. Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 1 / Issue 13 / Jan- June, 2012 / 33-36 DOI: http://dx.doi.org/10.3126/njog.v7i1.8833

B-Lynch Brace Suturing in primary post-partum hemorrhage during cesarean section

2003 ◽  
Vol 29 (5) ◽  
pp. 317-320 ◽  
Author(s):  
Manidip Pal ◽  
Asok Kumar Biswas ◽  
Sudhindra Mohan Bhattacharya
Keyword(s):  
Cesarean Section ◽  
Post Partum ◽  
Post Partum Hemorrhage

Abstract 118: Resuscitative Transfusion With Hemoglobin Vesicles in the Management of Post-Partum Hemorrhage

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Kohsuke Hagisawa ◽  
Manabu Kinoshita ◽  
Hiroki Ishibashi ◽  
Hiromi Sakai
Keyword(s):  
Cesarean Section ◽  
Hemorrhagic Shock ◽  
Fluid Resuscitation ◽  
Blood Cells ◽  
Post Partum ◽  
Femoral Vein ◽  
Late Gestation ◽  
Post Partum Hemorrhage ◽  
New Zealand White Rabbits ◽  
Hb Concentration

Background: We developed a Hemoglobin vesicles (HbV), which are artificial substitute for Red blood cells (RBCs). Objective: To evaluate the efficacy of HbV for alternative treatment instead of RBCs transfusion in rabbits with hemorrhagic shock due to post-partum hemorrhage. Methods: New Zealand white rabbits at late gestation underwent uncontrolled hemorrhagic shock by transecting a right mid-artery in the myometrium, after cesarean section of right side uterus. Initially, in the simulated ordinal treatment of bleeding, rabbits received colloid fluids (Voluven®) through an femoral vein with equivalent volume of the bleeding every 5 minutes. Once blood loss achieved 100ml, animals subsequently faced on critical hemorrhagic situation, where mean arterial pressure (MAP) reduced to approximately 48mmHg. They were randomly divided into three isovolemic resuscitation regimens: continuing colloid fluid resuscitation (n=4); transfusion of autologous washed RBCs with plasma (n=4); HbV infusion combining 5% human serum albumin (n=4). After 60 minutes of bleeding, all animals underwent surgical control of bleeding and cesarean section of left side uterus. Results: At the point of critical hemorrhagic situation, Hb concentration reduced to 4.8 g/dl. At the end of resuscitation, HbV infusion regained MAP and restored Hb concentration as well as RBCs transfusion, besides colloid fluid resuscitation exaggerated the severe hemorrhagic shock as shown in the table. Conclusions: HbV treatment may be effective in the management of post-partum hemorrhagic shock.

Intra-aortic balloon occlusion without fluoroscopy for life-threating post-partum hemorrhage

2016 ◽  
Vol 5 (1) ◽  
pp. 19-22
Author(s):  
Yuka Yamashita ◽  
Akihiro Kawashima ◽  
Junichi Hasegawa ◽  
Tomohiro Oba ◽  
Masamitsu Nakamura ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Balloon Occlusion ◽  
Post Partum Hemorrhage ◽  
Radical Treatment ◽  
Aortic Balloon Occlusion ◽  
Life Threatening ◽  
Endovascular Balloon Occlusion

Abstract The use of intra-aortic balloon occlusion (IABO) could be effective in achieving the quick control of bleeding in emergency settings and in supporting the provision of safe radical treatment through resuscitative endovascular balloon occlusion of the aorta (REBOA). We herein report our experience of a patient with life-threatening postpartum hemorrhage after cesarean section who was successfully treated by hysterectomy with IABO without fluoroscopy. We believe that this procedure is very useful and safe, and that it should be considered as one of methods for controlling bleeding in patients with life-threatening postpartum hemorrhage.

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