OBJECTIVE: To determine the efficacy and safety of intrauterine packing, in selected cases of postpartum hemorrhage in resource-poor settings.
PLACE ANDDURATION: The study was conducted at department of Obstetrics and Gynecology, Ghulam Muhammad Mahar Medical Teaching Hospital Khairpur Sindh during two year period from January 2011 to December 2012.
METHADOLOGY: Patients who delivered either vaginaly or caesarean section who developed intractable postpartum hemorrhage due to uterine atony, placenta previa, and coagulation failure not responding to medical treatment were included in the study. Firm packing was done with sterilize ribbon gauze, using learing technique under antibiotic cover. Packing was removed after 12-36 hours or earlier in case of failure to control hemorrhage. Pulse, blood pressure, soakage of pads, height of uterine fundus and temperature was monitored to assess for effectiveness and safety of the procedure. Data was analyzed by using SPSS 10.
RESULTS: During two year of study period 55 women presented with postpartum hemorrhage of whom 36(65%) were primipara while others 13(23.6%) and 6(10.9%) were multi and grandmultipara women respectively. More cases of PPH were seen in caesarean section 35(63.6%) and 20(36.3%) after vaginal delivery. Uterine atony unresponsive to syntocinon was the commonest cause of PPH seen in 74.5% cases. Intrauterine packing was successful in arresting hemorrhage in 48(87.2%) and failed in 7(12.7%) cases.
CONCLUSION: Whether used early or late uterine packing is an effective conservative method, help lower maternal death rates and minimize hysterectomies especially in resource-poor settings, because it is safe, quick and effective procedure for control of obstetric hemorrhage.
Key words: Postpartum hemorrhage, Resource-poor settings, intrauterine packing, maternal mortality.