The Bolbos technique for the management of uncontrollable intra-caesarean uterine bleeding.
OBJECTIVE
We describe a new conservative surgical technique for the management of intra-operative post-caesarean bleeding.


METHODS
This technique involves the application of ligation sutures to the main branches of the right and left uterine arteries at the level of the lower segment transverse uterine incision and a constriction suture to the lower segment of the posterior uterine wall.


RESULTS
We have used this method in nine cases and it was effective in controlling the bleeding in eight, thus avoiding the need for a more extensive procedure.


CONCLUSIONS
If medical management fails to control intra-operative post-caesarean bleeding, conservative surgery or even a caesarean hysterectomy may be required. Our technique is presented as a safe, simple, effective and readily reproducible alternative. Also, its effectiveness can be promptly assessed and if the bleeding persists, another, more complex procedure can be performed.
Bolbos
George
G
First Department of Obstetrics and Gynecology, Alexandra Maternity Hospital, Athens University, Athens, Greece. gbolbos6@hotmail.com
Sindos
Michael
M
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D006473:Postpartum Hemorrhage / Q000601:surgery*; D013536:Suture Techniques