Uterine packing in the management of complete placenta praeuvia

Niger J Med. 2014 Oct-Dec;23(4):321-4.

Abstract

Background: Complete (type 4) placenta praevia is a major cause of haemorrhage in Obstetrics. Uterine packing is an effective but underutilized life-saving intervention in situation of uncontrolled haemorrahage due to major placenta praevia.

Objectives: To reappraise the effectiveness of uterine packing in the management of complete placenta praevia in order to popularize the practice.

Methods: Seven case series of complete placenta praevia were managed with uterine packing in Enugu, Nigeria between January 2, 2012 and February 28, 2013.

Results and interpretation: Previous Caesarean delivery (85.71%) was the commonest identified risk factor for complete placenta praevia. Uterine packing was effective in preventing blood transfusion in 57.14% of the cases, and further post-operative intervention in 85.71%.Peripartum hysterectomy and maternal death were 100% avoidable.

Conclusions: Uterine packing is an effective life-saving intervention in management of complete placenta praevia. The technique should be considered whenever there is uncontrollable haemorrage following complete placenta praevia.

MeSH terms

  • Blood Loss, Surgical / prevention & control*
  • Cesarean Section / statistics & numerical data*
  • Female
  • Hemostasis, Surgical / methods*
  • Hemostasis, Surgical / statistics & numerical data
  • Hospitals, Teaching / statistics & numerical data
  • Humans
  • Nigeria / epidemiology
  • Placenta Previa / epidemiology
  • Placenta Previa / surgery*
  • Postpartum Hemorrhage / prevention & control*
  • Pregnancy
  • Treatment Outcome