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Control of Postpartum Hemorrhage Using Vacuum-Induced Uterine Tamponade [31M]

Segnitz, Jan MD; Arulkumaran, Sabaratnam MD PhD

doi: 10.1097/01.AOG.0000514702.64479.d1
Monday, May 8, 2017
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INTRODUCTION: Early arrest of postpartum hemorrhage (PPH) using a simple to use conservative technique, well before coagulopathy sets in, would reduce blood transfusions, unnecessary surgeries including hysterectomies, and maternal deaths. For cases of atonic PPH, a new device that uses vacuum force to collapse the uterus causing rapid tamponade, has been proposed. This may be a better alternative to balloon tamponade as it follows natural physiology, is easy to use, does not depend on guessing the volume of fluid to be introduced, or conceal bleeding behind the balloon. Our study sought to demonstrate safety, effectiveness, and ease of use in the deployment of this new device to treat PPH.

METHODS: Ten women, with vaginal deliveries in a hospital setting, treated with prophylactic uterotonics plus additional uterotonics for excessive bleeding, were the subjects of the study. When conservative medical therapy was failing and tamponade therapy was indicated, our device, that generates uniform vacuum-induced tamponade within the entire uterine cavity, was used with physiologic vacuum forces of 70 mmHg.

RESULTS: The ten women experienced 600-1,000 milliliters of blood loss before vacuum was generated. The vacuum created an immediate seal, 50-250 milliliters of blood were evacuated, the uterus collapsed and regained tone, and hemorrhaging stopped within 2 minutes in all cases. The device remained in place for an average of 2 hours.

CONCLUSION: This preliminary investigation suggests that a device designed to create vacuum-induced uterine tamponade may be a better alternative than balloon devices used to treat atonic PPH. Additional study is needed and is in progress.

Fogarty Institute for Innovation, Mountain View, CA

Financial Disclosure: Jan Segnitz disclosed the following—InPress Technologies Inc.: Consultant/Advisory Board, Ownership Interest includes stock, stock options, patent or other intellectual property. The other authors did not report any potential conflicts of interest.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.