Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Dec;132(6):1494-1497.
doi: 10.1097/AOG.0000000000002971.

Massive Hemorrhage From Suspected Iatrogenic Uterine Rupture

Kim T Nguyen  1 , M James Lozada, Phillip Gorrindo, Feyce M Peralta
Affiliations
Case Reports

Massive Hemorrhage From Suspected Iatrogenic Uterine Rupture

Kim T Nguyen et al. Obstet Gynecol. 2018 Dec.

Abstract

Background: Intrauterine balloon tamponade is recommended for refractory postpartum hemorrhage resulting from atony, but few studies have assessed complications associated with placement.

Case: A 39-year-old woman, gravida 4 para 1, with posterior placenta previa and suspected placenta accreta had a postpartum hemorrhage after a scheduled cesarean delivery. An intrauterine balloon tamponade device was easily placed transcervically; however, the patient required additional analgesia for constant severe stabbing pain worsened on examination. Three hours after placement, the balloon was expelled from the cervix, resulting in 1,500 mL of fresh blood and clot. Emergent exploratory laparotomy identified a uterine rupture inferior and lateral to the hysterotomy site.

Conclusion: Intrauterine balloon tamponade may contribute to iatrogenic uterine rupture and should be considered in patients with refractory hemorrhage, hemodynamic instability, or severe pain despite analgesia.

PubMed Disclaimer

References

    1. Postpartum hemorrhage. Practice Bulletin No. 183. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;130:e168–86.
    1. Prevention and management of postpartum haemorrhage: green-top guideline No. 52. BJOG 2017;124:e106–49.
    1. World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Available at: http://www.myilibrary.com?id=1003393. Retrieved June 8, 2018.
    1. Bakri YN, Amri A, Abdul Jabbar F. Tamponade-balloon for obstetrical bleeding. Int J Gynaecol Obstet 2001;74:139–42.
    1. Viteri O, Sibai B. Uterine balloon tamponade for the management of postpartum haemorrhage: a challenge and an opportunity for better evidence. BJOG 2018;125:540.

Publication types

LinkOut - more resources