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Uterus Wrapping: A Novel Concept in the Management of Uterine Atony during Cesarean Delivery.

Kimmich N, Engel W, Kreft M, Zimmermann R - Case Rep Obstet Gynecol (2015)

Bottom Line: Management strategies include medical treatment with uterotonic agents, manual compression of the uterus, and interventional or surgical procedures.A novel technique to compress the uterus by wrapping it with an elastic bandage and its outcome in 3 cases of uterine atony during cesarean section are presented.Our novel method of intermittent wrapping of the uterus during cesarean delivery seems to be a successful additional approach in the management of uterine atony during cesarean delivery and may be an alternative treatment option to other compressing procedures in order to avoid high blood loss and last but not least postpartum hysterectomy.

View Article: PubMed Central - PubMed

Affiliation: Division of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, 8006 Zurich, Switzerland.

ABSTRACT
Uterine atony during cesarean delivery is a serious cause of maternal morbidity and mortality. Management strategies include medical treatment with uterotonic agents, manual compression of the uterus, and interventional or surgical procedures. A novel technique to compress the uterus by wrapping it with an elastic bandage and its outcome in 3 cases of uterine atony during cesarean section are presented. Our novel method of intermittent wrapping of the uterus during cesarean delivery seems to be a successful additional approach in the management of uterine atony during cesarean delivery and may be an alternative treatment option to other compressing procedures in order to avoid high blood loss and last but not least postpartum hysterectomy.

No MeSH data available.


Related in: MedlinePlus

Wrapped uterus in case 2.
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fig1: Wrapped uterus in case 2.

Mentions: A 40-year-old iparous woman with a singleton pregnancy in vertex presentation presented herself to our obstetrical ward at 38 4/7 weeks of gestation for elective cesarean delivery because of a sonographically verified fetal malformation. Additional risk factors included gestational diabetes, treated with insulin, and a history of lumbar disc herniation. Hence, cesarean delivery was performed in general anesthesia. Because of uterine atony despite application of uterotonics as described in Table 1 and manual uterine compression, the uterus was exteriorized and wrapped as described above (Figure 1). After 18 minutes, the uterine bandage was removed, as the uterus seemed to be well contracted and really was. Then, the surgical procedure was completed. Total blood loss was 1100 mL.


Uterus Wrapping: A Novel Concept in the Management of Uterine Atony during Cesarean Delivery.

Kimmich N, Engel W, Kreft M, Zimmermann R - Case Rep Obstet Gynecol (2015)

Wrapped uterus in case 2.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4563056&req=5

fig1: Wrapped uterus in case 2.
Mentions: A 40-year-old iparous woman with a singleton pregnancy in vertex presentation presented herself to our obstetrical ward at 38 4/7 weeks of gestation for elective cesarean delivery because of a sonographically verified fetal malformation. Additional risk factors included gestational diabetes, treated with insulin, and a history of lumbar disc herniation. Hence, cesarean delivery was performed in general anesthesia. Because of uterine atony despite application of uterotonics as described in Table 1 and manual uterine compression, the uterus was exteriorized and wrapped as described above (Figure 1). After 18 minutes, the uterine bandage was removed, as the uterus seemed to be well contracted and really was. Then, the surgical procedure was completed. Total blood loss was 1100 mL.

Bottom Line: Management strategies include medical treatment with uterotonic agents, manual compression of the uterus, and interventional or surgical procedures.A novel technique to compress the uterus by wrapping it with an elastic bandage and its outcome in 3 cases of uterine atony during cesarean section are presented.Our novel method of intermittent wrapping of the uterus during cesarean delivery seems to be a successful additional approach in the management of uterine atony during cesarean delivery and may be an alternative treatment option to other compressing procedures in order to avoid high blood loss and last but not least postpartum hysterectomy.

View Article: PubMed Central - PubMed

Affiliation: Division of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, 8006 Zurich, Switzerland.

ABSTRACT
Uterine atony during cesarean delivery is a serious cause of maternal morbidity and mortality. Management strategies include medical treatment with uterotonic agents, manual compression of the uterus, and interventional or surgical procedures. A novel technique to compress the uterus by wrapping it with an elastic bandage and its outcome in 3 cases of uterine atony during cesarean section are presented. Our novel method of intermittent wrapping of the uterus during cesarean delivery seems to be a successful additional approach in the management of uterine atony during cesarean delivery and may be an alternative treatment option to other compressing procedures in order to avoid high blood loss and last but not least postpartum hysterectomy.

No MeSH data available.


Related in: MedlinePlus