Conservative approach in heavy postpartum hemorrhage associated with coagulopathy

Abstract

The application of external uterine elastic bandage is a new approach to control serious postpartum hemorrhage. This was applied in 10 consecutive patients with severe postpartum hemorrhage. After circulatory stabilization by external aortic compression, laparotomy and identification of the source of bleeding, compression sutures were applied and intrauterine fibrin glue was administered. Immediately thereafter, external uterine elastic bandage was wrapped around the uterus to compress it and stop the bleeding. After hemostasis had persisted for some time, the bandage was removed, and uterus and abdomen were then closed. Application of external uterine elastic bandage resulted in hemostasis within 45 minutes after aortic compression. Hysteroscopy 6 months after the procedure showed no signs of uterine ischemia or endometrial adhesions. In conclusion, external elastic uterine bandage is a simple tool that seems to improve hemostasis and prevent hysterectomy in heavy postpartum hemorrhage.