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Pelvic Umbrella Pack for Refractory Obstetric Hemorrhage Secondary to Posterior Uterine Rupture

Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama

Address reprint requests to: J. Michael Straughn, Jr, MD, University of Alabama at Birmingham, Division of Gynecologic Oncology, 619 South 19th Street, OHB Room 538, Birmingham, AL 35249; E-mail: jmstraughn{at}yahoo.com.

ABSTRACT

BACKGROUND: Pelvic hemorrhage continues to be a serious complication of pregnancy and can lead to significant maternal morbidity. The pelvic umbrella pack is a useful alternative to control pelvic bleeding when standard measures fail.

CASE: A patient with a previous low transverse cesarean delivery presented in active labor at term. After anuneventful vaginal delivery, defects in the posterior vaginal wall and lower uterine segment were identified. A hysterectomy with repair of the vaginal laceration was performed, but diffuse bleeding persisted. After routine surgical techniques failed to achieve adequate hemostasis, a pelvic umbrella pack was successfully used to tamponade pelvic bleeding.

CONCLUSION: In the event of continued hemorrhage after hysterectomy, bleeding that is uncontrolled by surgical intervention may be controlled with a pelvic umbrella pack.

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				G. A. Dildy, J. R. Scott, C. S. Saffer, and M. A. Belfort An Effective Pressure Pack for Severe Pelvic Hemorrhage. Obstet. Gynecol., November 1, 2006; 108(5): 1222 - 1226. [Abstract] [Full Text] [PDF]

				D. Nader, L. N. Parker, J. M. Straughn Jr, and D. J. Rouse Pelvic Umbrella Pack for Refractory Obstetric Hemorrhage Secondary to Posterior Uterine Rupture Obstet. Gynecol., March 1, 2003; 101(3): 616 - 617. [Full Text] [PDF]