title: Pelvic umbrella pack for refractory obstetric hemorrhage secondary to posterior uterine rupture.
abstract: BACKGROUND
  Pelvic hemorrhage continues to be a serious complication of pregnancy and can lead to significant maternal morbidity. The pelvic umbrella pack is a useful alternative to control pelvic bleeding when standard measures fail.
  
  
  METHODS
  A patient with a previous low transverse cesarean delivery presented in active labor at term. After an uneventful vaginal delivery, defects in the posterior vaginal wall and lower uterine segment were identified. A hysterectomy with repair of the vaginal laceration was performed, but diffuse bleeding persisted. After routine surgical techniques failed to achieve adequate hemostasis, a pelvic umbrella pack was successfully used to tamponade pelvic bleeding.
  
  
  CONCLUSIONS
  In the event of continued hemorrhage after hysterectomy, bleeding that is uncontrolled by surgical intervention may be controlled with a pelvic umbrella pack.
authors.affiliation: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA. jmstraughn@yahoo.com
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Howard
authors.forename: J Michael
authors.initials: JM
authors.lastname: Straughn
authors.forename: Warner K
authors.initials: WK
authors.lastname: Huh
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
mesh_terms: D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D007044:Hysterectomy; D007744:Obstetric Labor Complications / Q000601:surgery*; D011247:Pregnancy; D017211:Treatment Failure; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D014597:Uterine Rupture / Q000209:etiology / Q000601:surgery*; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects*