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Obstet Gynecol. 2006 Nov;108(5):1222-6.

An effective pressure pack for severe pelvic hemorrhage.

Author information

1
Department of Obstetrics and Gynecology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA. Gary.Dildy@HCAhealthcare.com

Abstract

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.

CONCLUSION:

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.

LEVEL OF EVIDENCE:

III.

[Indexed for MEDLINE]

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