Gynecology and Obstetrics Department, University Hospital Mongi Slim Hospital la Marsa, Tunis, Tunisia.
Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
Pan Afr Med J. 2023 Aug 31;45:192. doi: 10.11604/pamj.2023.45.192.39441. eCollection 2023.
postpartum hemorrhage is the main cause of maternal death worldwide. Uterine balloon packing has shown promising outcomes in PPH management. Nevertheless, its usage is limited in low- and middle-income countries due to associated costs. Uterine packing using gauzes presents a potentially efficient and cost-effective alternative. This study aims to assess the safety and efficacy of intra-uterine packing with gauzes in managing postpartum hemorrhage.
this was a retrospective study over a period of two years and six months. All patients who experienced PPH due to uterine atony during vaginal delivery, with no response to medical first-line treatment, were included. IUP using gauze was employed as a second-line intervention. The primary outcome was the success of postpartum hemorrhage management. Secondary outcomes included patient vitals, the need for blood transfusion, change in hemoglobin levels (delta Hemoglobin), and maternal morbidity (post-partum infection, Sheehan syndrome, and retained gauzes).
the study included 63 patients. The mean age was 30.06 ± 5.6, the mean gravida was 2.65 ± 1.9 and the mean para was 2.12 ± 1.31. None of these patients experienced major complications following gauze insertion. Three patients underwent laparotomy and conservative surgical management was performed. Hysterectomy was not required for any participant, and no maternal deaths were recorded.
产后出血是全球范围内导致产妇死亡的主要原因。子宫球囊填塞在产后出血的管理中显示出良好的效果。然而，由于相关费用，其在中低收入国家的应用受到限制。使用纱布进行宫腔填塞是一种具有潜在效率和成本效益的替代方法。本研究旨在评估纱布宫腔填塞在产后出血管理中的安全性和有效性。
这是一项为期两年零六个月的回顾性研究。所有因阴道分娩时子宫收缩乏力导致产后出血且对一线药物治疗无反应的患者均纳入研究。使用纱布进行宫腔填塞作为二线干预措施。主要结局是产后出血管理的成功率。次要结局包括患者生命体征、输血需求、血红蛋白水平变化（Delta Hemoglobin）和产妇发病率（产后感染、席汉综合征和纱布残留）。
该研究共纳入 63 例患者。平均年龄为 30.06 ± 5.6 岁，平均孕次为 2.65 ± 1.9，平均产次为 2.12 ± 1.31。这些患者在插入纱布后均未出现严重并发症。3 例患者接受了剖腹手术，进行了保守性手术治疗。没有患者需要进行子宫切除术，也没有记录到产妇死亡。
