title: Uterine packing in the combined management of obstetrical hemorrhage.
abstract: Uterine packing to control obstetrical hemorrhage has been generally discouraged over the past several decades. Intractable uterine hemorrhage postpartum or following an abortion is an extremely vexing management problem for the physician and continues to be a leading cause of maternal mortality. Uterine packing should be considered as a presurgical management tool after lacerations of the lower genital tract, uterine rupture, or retained products have been ruled out and when conventional therapy fails to control uterine hemorrhage. We describe two obstetrical patients with intractable uterine hemorrhage who were managed with uterine packing in combination with other methods of therapy. Causes of obstetrical hemorrhage and techniques of packing the uterus are discussed.
authors.affiliation: Department of Obstetrics & Gynecology, Tripler Army Medical Center, Honolulu, HI 96859-5000, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Wittich
authors.forename: E R
authors.initials: ER
authors.lastname: Salminen
authors.forename: E L
authors.initials: EL
authors.lastname: Hardin
authors.forename: R A
authors.initials: RA
authors.lastname: Desantis
mesh_terms: D000032:Abortion, Therapeutic / Q000009:adverse effects*; D000328:Adult; D016063:Blood Loss, Surgical; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D006473:Postpartum Hemorrhage / Q000628:therapy; D011247:Pregnancy; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy*