Role of Vaginal Packing in Prevention of Atonic Postpartum Hemorrhage

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Al-Manzala General Hospital, Ministry of Health, Egypt.

2 Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: Different treatment approaches were available for postpartum hemorrhage [PPH] [for example, medical uterotonic agents and interventional methods are in use]. However, the ideal option is not yet determined.  
Aim of the work: This study aimed to determine the effectiveness of vaginal packing in prevention and management of the primary atonic PPH.
Patients and methods: The current study included 98 females with high risk for atonic PPH after delivery. They were divided into two groups: group [A] included 49 females, received medical treatment only [[Oxytocin] 10 IU in 500 ml of saline infused at a rate of 250 mL per hour after delivery].  The other group [B] included 49 females, received the same medical treatment as in group A, plus aseptic vaginal packing. All women were evaluated in standard manner. Then intrapartum and postpartum blood loss was estimated, and hemoglobin change was recorded.
Results: Both groups were comparable regarding patient demographics and clinical data. Anemia was commonest risk factor in groups A and B [71.5% and 59.2%, respectively]. The postoperative bleeding, 4 hours after delivery was mainly minimal [73.4% and 87.8%, respectively]. Marked bleeding, however, was reported in 26.5% and 12.2% in groups A and B respectively. Packing was associated significantly with reduced postpartum blood loss, hemoglobin loss and shorter duration of hospital stay. For instance, the postpartum blood loss was significantly lower in B than A groups [248.5±88.6 vs 347.5±108.6 ml, respectively]. In addition, the change of hemoglobin was significantly lower in B than A groups [0.68±0.54 vs 0.93±0.69, respectively]. Furthermore, the duration of hospital stay was significantly shorter in B than A groups [17.14±6.0 vs 21.6±8.8 hours, respectively].
Conclusion: The vaginal packing is considered a safe and effective method for prevention of postpartum hemorrhage. It is a cheap and easy applicable procedure.

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