Main Article Content
Objective: To determine effectiveness of uterovaginal packing in control of primary postpartum hemorrhage.
Methodology: It was a prospective interventional study conducted at department of Obstetrics and Gynecology from Nov 2019 to May 2021. Sample size was calculated by WHO sample size calculator with 95% confidence interval and 5% Margin of error of estimation 16. Consecutive non probability sampling technique was utilized and 85 cases with postpartum hemorrhage were enrolled who were admitted through emergency and outpatient department. All women of reproductive age, any gravidity or parity presenting with postpartum hemorrhage due to uterine atony, coagulopathy or placental implantation site bleeding after vaginal or abdominal delivery were included. Cases with Genital tract injuries requiring repair, retained placental tissue or membranes requiring Evacuation & Curettage, uterine rupture requiring Laparotomy and secondary postpartum hemorrhage were excluded. All information was recorded in a pre-designed proforma and data was analyzed using SPSS version 20.
Results: Our study included 85 women with 62.35% normal vaginal deliveries and 37.65% with cesarean section, uterine atony found to be the top most cause of postpartum hemorrhage (47.1%). Success rate of uterovaginal packing remained high i.e 95.3%
Conclusion: Our study concludes that Uterovaginal packing was 95.3% effective in the controls of postpartum hemorrhage. It is a quick and effective recovery to control postpartum hemorrhage conservatively.
Work published in JPMI is licensed under a
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Herrick T, Mvundura M, Burke TF, Abu-Haydar E. A low-cost uterine bal¬loon tamponade for management of postpartum hemorrhage: modeling the potential impact on maternal mor¬tality and morbidity in sub-Saharan Africa. BMC Pregnancy Childbirth. 2017;17(1):374-80. DOI:10.1186/ s12884-017-1564-5
Mousa HA, Walkinshaw S. Major post¬partum haemorrhage. Curr Opin Obstet Gynecol. 2001;13(6):595-603. DOI: 10.1097/00001703-200112000- 00008.
Sheldon WR, Blum J, Vogel JP, Souza JP, Gülmezoglu AM, Winikoff B. Post¬partum hemorrhage management, risks, and maternal outcomes: Find¬ings from the world health organization multicountry survey on maternal and newborn health. Obstet Anesth Dig. 2015;35(1):25-6. DOI:10.1097/01. aoa.0000460395.75349.79
WHO recommendations for the pre¬vention and treatment of postpar¬tum haemorrhage. Genève, Swit-zerland: World Health Organization; 2012. Available from URL: https:// apps.who.int/iris/bitstream/han¬dle/10665/75411/9789241?se¬quence=1
Kerr R, Eckert LO, Winikoff B, Durocher J, Meher S, Fawcus S, et al. Postpar¬tum haemorrhage: Case definition and guidelines for data collection, analysis, and presentation of immunization safe¬ty data. Vaccine. 2016;34(49):6102-9. DOI:10.1016/j.vaccine.2016.03.039
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A-B, Daniels J, et al. Global causes of maternal death: a WHO sys¬tematic analysis. Lancet Glob Health. 2014;2(6):e323-33. DOI:10.1016/ S2214-109X(14)70227-X
Maswime S, Buchmann E. A systematic review of maternal near miss and mor¬tality due to postpartum hemorrhage. Int J Gynaecol Obstet. 2017;137(1):1- 7. DOI:10.1002/ijgo.12096
National Institute of population stud¬ies 2008. Pakistan Demographic and Health Survey 2007: Key findings. Calverton, Maryland, USA: NIPS and Macro International [cited 2021 Jun 3]. Available from URL: https://res.nipspor¬tal.com/publications/123.pdf
Attending to 136 million births, ev¬ery year: make every mother and child count: the world report. Gene¬va, Switzerland, WHO; 2005. Who. int. [cited 2021 Jun 3]. Available from URL:https://apps.who.int/iris/bitstream/ handle/10665/43131/9241562900. pdf?sequence=1
Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spongo CY, Wil¬liams Obstetrics. 23rd Edition. MC Graw Hill Medicine. New York. 2010;757-98.
Arias F, Bhide AG, SA, Damania K, Daftary SN. Practical guide to high risk pregnancy and delivery. 3rd ed. New Delhi (India): Elsevier; 2012.
Lokugamage AU, Sullivan KR, Nicules¬cu I, Tigere P, Onyangunga F, Refaey HE, et al. A randomized study compar¬ing rectally administered misoprostol versus Syntometrine combined with an oxytocin infusion for the cessa¬tion of primary post partum hemor¬rhage. Acta Obstet Gynecol Scand. 2001;80(9):835-9. DOI:10.1080/ j.1600-0412.2001.080009835.x
Pahlavan P, Nezhat C, Nezhat C. Hemor¬rhage in obstetrics and gynecology. Curr Opin Obstet Gynecol. 2001;13(4):419- 24. DOI:10.1097/00001703- 200108000-00008.
Hsu S, Rodgers B, Lele A, Yeh J. Use of packing in obstetric hemorrhage of uterine origin. Obstet Gynecol Surv. 2003;58(8):515-6. DOI: 10.1097/01. ogx.0000079644.05271.30
Yong S, Pradhan M. Intrauterine Gauze Packing in Primary Post Partum Hem¬orrhage following Caesarean section: A Clinical study. Nepal J Obstet Gynaecol. 2013;7(1):33-6. DOI:10.3126/njog. v7i1.8833
Yasser IK. Therapeutic evaluation of the partial movement of the center of the neural bundle according to its standard components to determine the contri¬bution rates of its standard compo¬nents. J Med Sci Clin Res. 2018;6(8). DOI:10.18535/jmscr/v6i8.30
Javed L, Munir SI, Eusaph AZ. Effective¬ness of utero-vaginal packing in man¬agement of postpartum hemorrhage. Ann King Edw Med Univ. 2017;23(1):58- 62. DOI:10.21649/akemu.v23i1.1513
Bibi S, Gul K, Bukhsh FM, Gul P. Uterovaginal Packing in the Manage¬ment of primary Post Partum Hemor¬rhage in Tertiary Care Hospital: A five year Clinical study J. Soc. Obstet. Gy¬naecol. Pak. 2018;8(3):185-8.
Qadir M, Amir S. To determine the effi¬cacy of uterine packing in management of primary postpartum haemorrhage. J Saidu Med Coll Swat. 2017;7(2):79-82. DOI: 10.52206/jsmc.2017.7.2.%25p
Pradhan B, Rc L, Sharma P, Singh A. Uterovaginal packing as treatment in primary postpartum hemorrhage in Pa¬tan hospital. Nepal J Obstet Gynaecol. 2016;11(1):44-6.
Haq G, Tayyab S. Control of postpar¬tum and post abortal haemorrhage with uterine packing. J Pak Med Assoc. 2005;55(9):369-71.
Wittich AC, Salminen ER, Hardin EL, De¬santis RA. Uterine packing in the com¬bined management of obstetrical hem¬orrhage. Mil Med. 1996;161(3):180-2. DOI:10.1093/milmed/161.3.180
Rathore AM, Gupta S, Manaktala U, Gupta S, Dubey C, Khan M. Uterine tamponade using condom catheter balloon in the management of non-traumatic postpar¬tum hemorrhage: Condom balloon tam-ponade in PPH. J Obstet Gynaecol Res. 2012;38(9):1162-7. DOI:10.1111/ j.1447-0756.2011.01843.x
Akhtar KT, Tabassum S, Siddique S. Ef¬ficacy of balloon tamponade in control of primary postpartum haemorrhage (PPH). Prof Med J. 2020;27(04):717-20. DOI:10.29309/tpmj/2020.27.04.3423
Nizam K, Haider G. Role of Uterovagi¬nal packing in postpartum hemorrhage. JLUMHS 2010; 9(1):27-9.
Sarkar M, Jane SK, Bhar D, Mandal SK, Halder PS, Das AK. Uterovaginal pack¬ing with rolled gauze in postpartum hemorrhage: A prospective study of an Indian Medical College. J Med Med Sci. 2011;2(7):985-9.
Bagga R, Jain V, Kalra J, Chopra S, Gopalan S. Uterovaginal packing with rolled gauze in postpartum hemorrhage. Med Gen Med. 2004;6(1):50.
Dabelea V, Schultze PM, McDuffie RS Jr. Intrauterine balloon tamponade in the management of postpartum hemor¬rhage. Am J Perinatol. 2007;24(6):359- 64. DOI:10.1055/s-2007-984402
Ali T, Ghazi A, Siddique NM. Uterovag¬inal Packing in massive postpartum hemorrhage – A re-appraisal.PK J Surg 2008; 24(1): 57-9 Available from URL: http://www.pjs.com.pk/journal_pdfs/ jan_march08/15.pdf
Suarez S, Conde AA, Borovac PA, Suarez RD, Eckardt M, Theron G, et al. Uterine balloon tamponade for the treatment of postpartum hemorrhage: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;222(4):293.1-293.52. DOI:10.1016/j.ajog.2019.11.1287
Bhatti K, Lashari A, Mahar T, Hafeez R. Intrauterine packing in postpartum hemorrhage still a life saving procedure in resource settings. Rawal Medical J. 2014;39(4):432-4.
Marwah A, Singh P, National A. Role of intrauterine packing in primary post¬partum hemorrhage. Int J Sci Res. 2016;5(7):209-18.