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Control of Postpartum Hemorrhage Using Vacuum-Induced Uterine Tamponade

Purwosunu, Yuditiya MD; Sarkoen, Widyastuti MD; Arulkumaran, Sabaratnam MD, PhD; Segnitz, Jan MD

doi: 10.1097/AOG.0000000000001473
Contents: Global Health: Procedures and Instruments
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BACKGROUND: Postpartum hemorrhage is the leading cause of maternal mortality worldwide. Vacuum-induced uterine tamponade is a possible alternative approach to balloon tamponade systems for the treatment of postpartum hemorrhage resulting from atony.

METHOD: In a prospective proof-of-concept investigation of 10 women with vaginal deliveries in a hospital setting who failed first-line therapies for postpartum hemorrhage, tamponade was used. Vacuum-induced uterine tamponade was created through a device inserted transvaginally into the uterine cavity. An occlusion balloon built into the device shaft was inflated at the level of the external cervical os to create a uterine seal. Negative pressure was created by attaching a self-contained, mobile, electrically powered, pressure-regulated vacuum pump with a sterile graduated canister.

EXPERIENCE: In all 10 cases, the suction created an immediate seal at the cervical os, 50–250 mL of residual blood was evacuated from the uterine cavity, the uterus collapsed and regained tone within minutes, and hemorrhaging was controlled. The device remained in place for a minimum of 1 hour and up to 6.5 hours in one case while vaginal and perineal lacerations were easily repaired.

CONCLUSION: This preliminary investigation suggests that a device designed to create vacuum-induced uterine tamponade may be a reasonable alternative to other devices used to treat atonic postpartum hemorrhage.

Vacuum-induced uterine tamponade may be an effective alternative to balloon tamponade systems for treating patients with postpartum hemorrhage resulting from atony.

Department of Obstetrics and Gynecology, University of Indonesia, Jakarta, Indonesia; St. George's Medical School, London, England; and the Fogarty Institute for Innovation, San Luis Obispo, California.

Corresponding author: Jan Segnitz, MD, InPress Technologies Inc, 955 Morro Street, San Luis Obispo, CA 93401; e-mail: jsegnitz@gmail.com.

Supported by InPress Technologies Inc, San Luis Obispo, California, who provided the devices for the study and provided technical support during the procedures. Assistance with the preparation of the manuscript was provided by Discovery Statistics, San Clemente, California.

Financial Disclosure Dr. Segnitz has been given stock options as part of compensation for services as a medical advisor. He is the Chief Medical Officer for InPress Technologies Inc, the company who has developed the InPress Device for control of postpartum hemorrhage. The other authors did not report any potential conflicts of interest.

Presented at the Asian and Oceanic Congress of Obstetrics and Gynaecology, June 3–6, 2015, Sarawak, Malaysia.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.