Management of Postpartum Hemorrhage With a Mini-Sponge Tamponade Device.
Journal
Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
pubmed:
9
10
2020
medline:
1
12
2020
entrez:
8
10
2020
Statut:
ppublish
Résumé
Postpartum hemorrhage is a leading cause of maternal mortality globally. A tamponade agent that can be quickly and easily placed in a range of settings could advance the treatment of atonic hemorrhage. We adapted a highly effective trauma dressing for use in postpartum hemorrhage. This mini-sponge tamponade device is comprised of two components: compressed mini-sponges contained within a strong mesh pouch and a tubular applicator. Compressed mini-sponges rapidly absorb blood, expand within seconds, and exert sustained pressure uniformly to bleeding sites. The sponges are deployed within a mesh pouch to facilitate simple vaginal removal. We successfully placed the mini-sponge device in nine patients experiencing postpartum hemorrhage after vaginal birth, with resolution of bleeding within 1 minute. The mean time to place the device was 62 seconds. Uterine fill was documented in all cases by ultrasound scan, and device placement was rated as "easy" to "very easy." Mini-sponges were left in place on average for 1 hour (0.5 hours-14 hours). Bleeding did not recur. There were no adverse events; all patients remained afebrile and did not require subsequent surgical intervention. This study supports further evaluation of the mini-sponge device for the management of postpartum hemorrhage. This study was funded by OBSTETRX, Inc.
Sections du résumé
BACKGROUND
Postpartum hemorrhage is a leading cause of maternal mortality globally. A tamponade agent that can be quickly and easily placed in a range of settings could advance the treatment of atonic hemorrhage.
METHOD
We adapted a highly effective trauma dressing for use in postpartum hemorrhage. This mini-sponge tamponade device is comprised of two components: compressed mini-sponges contained within a strong mesh pouch and a tubular applicator. Compressed mini-sponges rapidly absorb blood, expand within seconds, and exert sustained pressure uniformly to bleeding sites. The sponges are deployed within a mesh pouch to facilitate simple vaginal removal.
EXPERIENCE
We successfully placed the mini-sponge device in nine patients experiencing postpartum hemorrhage after vaginal birth, with resolution of bleeding within 1 minute. The mean time to place the device was 62 seconds. Uterine fill was documented in all cases by ultrasound scan, and device placement was rated as "easy" to "very easy." Mini-sponges were left in place on average for 1 hour (0.5 hours-14 hours). Bleeding did not recur. There were no adverse events; all patients remained afebrile and did not require subsequent surgical intervention.
CONCLUSION
This study supports further evaluation of the mini-sponge device for the management of postpartum hemorrhage.
FUNDING
This study was funded by OBSTETRX, Inc.
Identifiants
pubmed: 33030862
doi: 10.1097/AOG.0000000000004135
pmc: PMC7575022
pii: 00006250-202011000-00003
doi:
Types de publication
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
876-881Commentaires et corrections
Type : CommentIn
Références
Am J Perinatol. 2007 Jun;24(6):359-64
pubmed: 17566947
J Trauma Acute Care Surg. 2019 Mar;86(3):424-430
pubmed: 30358771
Am J Obstet Gynecol. 2020 Apr;222(4):293.e1-293.e52
pubmed: 31917139
J Spec Oper Med. 2016 Spring;16(1):19-28
pubmed: 27045490
BJOG. 2019 Dec;126(13):1612-1621
pubmed: 31410966
J Spec Oper Med. 2017 Fall;17(3):64-67
pubmed: 28910471
BMC Pregnancy Childbirth. 2017 Jun 13;17(1):187
pubmed: 28610569
Int J Gynaecol Obstet. 2001 Aug;74(2):139-42
pubmed: 11502292
Am J Obstet Gynecol. 1993 Aug;169(2 Pt 1):317-21; discussion 321-3
pubmed: 8362942
Mil Med. 2019 Mar 1;184(Suppl 1):367-373
pubmed: 30901449
Aust N Z J Obstet Gynaecol. 2009 Apr;49(2):191-4
pubmed: 19432609
Int J Gynaecol Obstet. 1992 Apr;37(4):302-3
pubmed: 1350550
J Trauma Acute Care Surg. 2012 Aug;73(2 Suppl 1):S134-9
pubmed: 22847084