Use of a fascial prosthesis for management of abdominal compartment syndrome secondary to obstetric hemorrhage.
BACKGROUND
Massive obstetric hemorrhage can be catastrophic, with considerable maternal morbidity and mortality.


METHODS
A 41-year-old term gravida experienced massive postpartum hemorrhage attributed to an amniotic fluid embolism with rapid development of disseminated intravascular coagulation and resultant abdominal compartment syndrome. In this critically ill patient, a fascial prosthesis used for abdominal wall closure was placed to expedite multiple abdominal explorations and packing. Additionally, this device facilitated fascial closure once the abdominal compartment syndrome was resolved.


CONCLUSIONS
Abdominal compartment syndrome resulting from overwhelming obstetric hemorrhage may necessitate emergent decompressive laparotomy to alleviate increased intra-abdominal pressure and end-organ dysfunction. The fascial prosthesis allows a staged abdominal wall closure to be performed once the abdominal compartment syndrome is resolved.
Kendrick
James E
JE
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. tommy.kendrick@obgyn.uab.edu
Leath
Charles A
CA
Melton
Sherry M
SM
Straughn
J Michael
JM
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D019736:Prostheses and Implants