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Balloon Uterine Tamponade Device After Peripartum Hysterectomy for Morbidly Adherent Placenta

Waks, Ashten, MD; Tabsh, Kareem, MD; Tabsh, Khalil, MD; Afshar, Yalda, MD, PhD

doi: 10.1097/AOG.0000000000002792
Contents: Maternal Morbidity and Mortality: Case Report

BACKGROUND: Perioperative hemorrhage is a common complication of peripartum hysterectomy for morbidly adherent placenta. We present an application of a balloon uterine tamponade device in the setting of a cesarean delivery and subsequent supracervical hysterectomy for abnormal placentation.

CASE: A 33-year-old gravid woman, 6 para 3022, at 33 2/7 weeks of gestation was admitted in preterm labor, with placenta previa and suspected morbidly adherent placenta, for a planned cesarean delivery and hysterectomy. After supracervical hysterectomy, colloid resuscitation and packing failed to provide hemostasis. A transcervical balloon uterine tamponade device subsequently was placed intraperitoneally and left on tension owing to the need for further tamponade.

CONCLUSION: Use of a balloon uterine tamponade device intraperitoneally posthysterectomy was associated with hemorrhage control. This application may facilitate timely management and streamlining of obstetric resources for postpartum hemorrhage.

Transcervical intraperitoneal balloon uterine tamponade device placement was followed by hemorrhage control after supracervical cesarean delivery and hysterectomy for morbidly adherent placenta.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Arizona, Tucson, Tucson, Arizona.

Corresponding author: Yalda Afshar, MD, PhD, Department of Obstetrics and Gynecology, David Geffen School of Medicine, UCLA, 10833 Le Conte Avenue, Room 27-139 CHS, Los Angeles, CA 90095; email: yafshar@mednet.ucla.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal's requirements for authorship.

Received March 28, 2018

Received in revised form May 15, 2018

Accepted June 07, 2018

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.