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

N Kimmich,W Engel,M Kreft,R Zimmermann

doi:10.1155/2015/195696

N Kimmich, W Engel + Show 2 more

Open Access

https://doi.org/10.1155/2015/195696

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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.

Highlights

Uterine atony with severe hemorrhage is a serious cause of maternal morbidity and mortality
Uterine atony during cesarean delivery is a serious cause of maternal morbidity and mortality
We developed a novel technique to compress the uterus in case of uterine atony during cesarean delivery by wrapping the uterus

Summary

Introduction

Uterine atony with severe hemorrhage is a serious cause of maternal morbidity and mortality. In addition to medical treatment by uterotonic agents, manual compression/massage of the uterus and interventional or surgical procedures are performed [1]. Those procedures include embolization of the uterine artery, uterine packing with gauze [2], uterine compression sutures [3,4,5,6,7], tamponade of the uterus by application of a balloon [8], bilateral arcuate artery suture [9], and ligation of the uterine artery. The aim of all these treatment options is to reduce blood loss and to avoid hysterectomy in order to sustain maternal fertility. We developed a novel technique to compress the uterus in case of uterine atony during cesarean delivery by wrapping the uterus

Case Presentation

Technique of Uterus Wrapping

Case 1

Case 2

Case 3

Discussion