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

Howard, Rebecca J.; Straughn, J. Michael Jr MD; Huh, Warner K. MD; Rouse, Dwight J. MD

Obstetrics & Gynecology:
Case Reports
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.

In Brief

The use of a pelvic umbrella pack can be lifesaving in the event of refractory obstetric hemorrhage.

Author Information

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@yahoo.com.

Received November 27, 2001. Received in revised form January 30, 2002. Accepted February 21, 2002.

© 2002 The American College of Obstetricians and Gynecologists