An effective pressure pack for severe pelvic hemorrhage.
OBJECTIVE
To evaluate our experience with the "pelvic pressure pack," a surgical technique for controlling posthysterectomy bleeding.


METHODS
This is an observational descriptive report of cases collected by the authors during the years 1968-2006. Packs were constructed of various materials (eg, pillow cases, gauze sheets, plastic X-ray cassette drapes, or orthopedic stockings) filled with gauze rolls introduced abdominally and exiting the vagina.


RESULTS
We report 11 new cases (10 obstetric and one gynecologic). Massive red blood cell transfusion and coagulopathy occurred in all cases. The pelvic pressure pack successfully controlled bleeding in 82% (9 of 11) of cases. Postoperative febrile morbidity occurred in most cases. There were no maternal deaths.


CONCLUSIONS
In the contemporary management of posthysterectomy bleeding, the pelvic pressure pack appears to be a valuable surgical option, affording correction of coagulopathy and further stabilization. Given near-universal postoperative febrile morbidity in our series, prophylactic broad-spectrum antibiotic therapy should be strongly considered. We believe all obstetrician-gynecologists should be familiar with this simple, potentially life-saving technique.


METHODS
III.
Dildy
Gary A
GA
Department of Obstetrics and Gynecology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA. Gary.Dildy@HCAhealthcare.com
Scott
James R
JR
Saffer
Craig S
CS
Belfort
Michael A
MA
D000328:Adult; D001458:Bandages; D017707:Erythrocyte Transfusion; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D011312:Pressure; D012189:Retrospective Studies; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy*