Obstetrics & Gynecology Track the topics, authors and articles important to you
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 2006;108:1222-1226
© 2006 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dildy, G. A.
Right arrow Articles by Belfort, M. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dildy, G. A.
Right arrow Articles by Belfort, M. A.
Related Collections
Right arrow Critical Care
Right arrow General gynecology
Right arrow General obstetrics
Right arrow Labor and operative obstetrics
Right arrow Obstetric complications of pregnancy

ORIGINAL RESEARCH

An Effective Pressure Pack for Severe Pelvic Hemorrhage

Gary A. Dildy, MD1, James R. Scott, MD2, Craig S. Saffer, MD3 and Michael A. Belfort, MD, PhD2

From the 1Department of Obstetrics & Gynecology, Louisiana State University School of Medicine, New Orleans, Louisiana; 2Department of Obstetrics & Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah; and 3Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas.

OBJECTIVE: To evaluate our experience with the "pelvic pressure pack," a surgical technique for controlling posthysterectomy bleeding.

METHODS: This is an observational descriptive report of cases collected by the authors during the years 1968–2006. Packs were constructed of various materials (eg, pillow cases, gauze sheets, plastic X-ray cassette drapes, or orthopedic stockings) filled with gauze rolls introduced abdominally and exiting the vagina.

RESULTS: We report 11 new cases (10 obstetric and one gynecologic). Massive red blood cell transfusion and coagulopathy occurred in all cases. The pelvic pressure pack successfully controlled bleeding in 82% (9 of 11) of cases. Postoperative febrile morbidity occurred in most cases. There were no maternal deaths.

CONCLUSION: In the contemporary management of posthysterectomy bleeding, the pelvic pressure pack appears to be a valuable surgical option, affording correction of coagulopathy and further stabilization. Given near-universal postoperative febrile morbidity in our series, prophylactic broad-spectrum antibiotic therapy should be strongly considered. We believe all obstetrician-gynecologists should be familiar with this simple, potentially life-saving technique.

LEVEL OF EVIDENCE: III






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American College of Obstetricians and Gynecologists.