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.
The use of a pelvic umbrella pack can be lifesaving in the event of refractory obstetric hemorrhage.
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: firstname.lastname@example.org.
Received November 27, 2001. Received in revised form January 30, 2002. Accepted February 21, 2002.