Gynecology & Obstetrics Case report Open Access

Uterine compression: old and new dialogues for PPH

Annual Conference on Gynecology, Obstetrics & Reproductive Health

August 23-24 ,2018 Amsterdam,Netherlands

Christos Tsitlakidis

Pinderfields Hospital, MidYorkshire NHS Trust, UK

Posters & Accepted Abstracts: Gynecol Obstet Case Rep

Abstract:

Introduction: It is since 1834 when Dr. Beatty’s Contributions to Midwifery published and yet the defiance of post-partum haemorrhage (PPH) is causing a staggering number of maternal deaths. Should uterine compression the most undervalued means in our management be used in more ways, could change that outcome? Purpose: To show old and new methods of uterine compression; to revise the role of uterine compression in the management of PPH as a primary or secondary measure for controlling bleeding; to stage the degree of the compression applied. Methods: 1) Waist band application around woman’s abdomen at level of uterine fundus and compression of uterus in photo dated 1927, similarities with the pressure ball from sector 5 of the NASG applications. 2) Compressing the uterus by forcing the fundus manually downwards to the pelvic floor. This technique is helpful during perineal repair. 3) During Caesarean, two large gauge packs placed in paracolic gutters, apply pressure onto uterine vessels and the uterus. 4) Exteriorisation of the uterus during caesarean allows a bimanual compression. 5) Closing the uterus in two layers in the normal way but then running an interrupted stitch alongside the incision and compressing the lower segment. Staging of compression: mild for oxytocics and external compression, abdominal packs, uterine closure modification, moderate for bimanual compression, Severe for compressing sutures and intrauterine balloons. Conclusion: Speaking with the decisiveness that comes only from experience, the uterine compression seems the most successful remedy for PPH. Giving the old companion such a consideration could show a massive decrease in maternal morbidity.

Biography :

Christos Tsitlakidis has graduated from Hellenic Aristotle University School of Medicine. He is a Consultant Obstetrician and Gynaecologist in Pinderfields Hospital, MidYorkshire NHS Trust, United Kingdom. He has published more than 6 papers in reputed journals in UK and abroad and has been member of the RCOG.

E-mail: ctsitlakidis@yahoo.co.uk