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Uterine balloon tamponade in combination with topical administration of tranexamic Acid for management of postpartum hemorrhage.

Kinugasa M, Tamai H, Miyake M, Shimizu T - Case Rep Obstet Gynecol (2015)

Bottom Line: In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort.This method brought complete hemostasis and no further treatments were needed.Both the women left hospital in stable condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Amagasaki Co-Op Hospital, 12-16-1 Minamimukonoso, Amagasaki, Hyogo Prefecture 661-0033, Japan.

ABSTRACT
While uterine balloon tamponade is an effective modality for control of postpartum hemorrhage, the reported success rates have ranged from the level of 60% to the level of 80%. In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort. We developed a modified tamponade method and applied it to two cases of refractory postpartum hemorrhage after vaginal delivery. The first case was accompanied by uterine myoma and low-lying placenta. After an induced delivery, the patient had excessive hemorrhage due to uterine atony. Despite oxytocin infusion and bimanual uterine compression, the total blood loss was estimated at 2,800 mL or more. The second case was diagnosed as placental abruption complicated by fetal death and severe disseminated intravascular coagulation, subsequently. A profuse hemorrhage continued despite administration of uterotonics, fluid, and blood transfusion. The total blood loss was more than 5,000 mL. In each case, an intrauterine balloon catheter was wrapped in gauze impregnated with tranexamic acid, inserted into the uterus, and inflated sufficiently with sterile water. In this way, mechanical compression by a balloon and a topical antifibrinolytic agent were combined together. This method brought complete hemostasis and no further treatments were needed. Both the women left hospital in stable condition.

No MeSH data available.


Related in: MedlinePlus

The catheter with the rolled gauze is inserted gently into the uterine cavity using ring forceps. A lubricating jelly may be applied on the tip of the catheter, if needed.
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fig3: The catheter with the rolled gauze is inserted gently into the uterine cavity using ring forceps. A lubricating jelly may be applied on the tip of the catheter, if needed.


Uterine balloon tamponade in combination with topical administration of tranexamic Acid for management of postpartum hemorrhage.

Kinugasa M, Tamai H, Miyake M, Shimizu T - Case Rep Obstet Gynecol (2015)

The catheter with the rolled gauze is inserted gently into the uterine cavity using ring forceps. A lubricating jelly may be applied on the tip of the catheter, if needed.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4377388&req=5

fig3: The catheter with the rolled gauze is inserted gently into the uterine cavity using ring forceps. A lubricating jelly may be applied on the tip of the catheter, if needed.
Bottom Line: In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort.This method brought complete hemostasis and no further treatments were needed.Both the women left hospital in stable condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Amagasaki Co-Op Hospital, 12-16-1 Minamimukonoso, Amagasaki, Hyogo Prefecture 661-0033, Japan.

ABSTRACT
While uterine balloon tamponade is an effective modality for control of postpartum hemorrhage, the reported success rates have ranged from the level of 60% to the level of 80%. In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort. We developed a modified tamponade method and applied it to two cases of refractory postpartum hemorrhage after vaginal delivery. The first case was accompanied by uterine myoma and low-lying placenta. After an induced delivery, the patient had excessive hemorrhage due to uterine atony. Despite oxytocin infusion and bimanual uterine compression, the total blood loss was estimated at 2,800 mL or more. The second case was diagnosed as placental abruption complicated by fetal death and severe disseminated intravascular coagulation, subsequently. A profuse hemorrhage continued despite administration of uterotonics, fluid, and blood transfusion. The total blood loss was more than 5,000 mL. In each case, an intrauterine balloon catheter was wrapped in gauze impregnated with tranexamic acid, inserted into the uterus, and inflated sufficiently with sterile water. In this way, mechanical compression by a balloon and a topical antifibrinolytic agent were combined together. This method brought complete hemostasis and no further treatments were needed. Both the women left hospital in stable condition.

No MeSH data available.


Related in: MedlinePlus