Transvaginal pressure pack for life-threatening pelvic hemorrhage secondary to placenta accreta.
A patient with placenta previa presented with severe vaginal bleeding. Emergency classical cesarean was followed by hysterectomy for placenta accreta. The patient's hemodynamic status continued to deteriorate and she subsequently developed a consumptive coagulopathy secondary to massive hemorrhage. A mushroom-shaped pack, created from a sterile plastic bag filled with Kerlix gauze, was placed in the pelvis and brought out through the vagina. Traction on the pack produced pressure against the pelvic floor, controlling the bleeding. This pack was prepared quickly and removed without complication in the immediate postoperative period.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
M
M
Hallak
G A
GA
Dildy
T J
TJ
Hurley
K J
KJ
Moise
D000328:Adult; D001458:Bandages; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007044:Hysterectomy; D010921:Placenta Accreta / Q000601:surgery*; D011183:Postoperative Complications; D011247:Pregnancy; D011312:Pressure; D013921:Thrombocytopenia / Q000097:blood / Q000150:complications*; D014143:Traction; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy*; D014621:Vagina