title: Use of packing in obstetric hemorrhage of uterine origin.
abstract: OBJECTIVE
  To determine the safety and effectiveness of uterine packing to stop hemorrhage in obstetric patients following delivery and pregnancy termination.
  
  
  METHODS
  A review of obstetric records at Children's Hospital of Buffalo in a 9-year period was undertaken. Patients with uterine packing were identified. Indications, additional medical and surgical procedures, estimated blood loss, postoperative complications and packing material used were reviewed.
  
  
  RESULTS
  A total of 9 patients were identified among 34,071. Five patients had hemorrhage during cesarean section. Two patients had hemorrhage after vaginal delivery; 1 case of which had failure with packing and resulted in postpartum hysterectomy. The remaining 2 patients had hemorrhage after dilation and evacuation. Uterine atony unresponsive to oxytocics was the most common indication for uterine packing (44%). The average hematocrit decrease was 10.4% (average total blood loss, 2,200 mL), and all patients received transfusion except 1. The only immediate postoperative complications occurred in a patient with postpartum hysterectomy after failed packing; she developed a pelvic abscess but did well after drainage.
  
  
  CONCLUSIONS
  Uterine packing may be a reasonable alternative to further surgical intervention in patients with intractable obstetric hemorrhage who wish to preserve fertility.
authors.affiliation: Department of Gynecology and Obstetrics, State University of New York, Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA. hsusz@yahoo.com
authors.forename: Senzan
authors.initials: S
authors.lastname: Hsu
authors.forename: Bruce
authors.initials: B
authors.lastname: Rodgers
authors.forename: Amol
authors.initials: A
authors.lastname: Lele
authors.forename: John
authors.initials: J
authors.lastname: Yeh
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006489:Hemostatic Techniques; D006801:Humans; D007744:Obstetric Labor Complications / Q000628:therapy; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000628:therapy*