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Case Reports
. 2019 Jan;9(1):e27-e29.
doi: 10.1055/s-0039-1678735. Epub 2019 Feb 13.

A Novel Treatment for Massive Hemorrhage after Maternal Trauma in Pregnancy

Maritza G Gonzalez  1 , Ruth M Wei  1 , Kenneth D Hatch  1 , Lynn M Gries  2 , Meghan G Hill  1
Affiliations
Case Reports

A Novel Treatment for Massive Hemorrhage after Maternal Trauma in Pregnancy

Maritza G Gonzalez et al. AJP Rep. 2019 Jan.

Abstract

Background Trauma in pregnancy can lead to life-threatening hemorrhage. Conventional treatments of hemorrhage include medical and surgical management. However, if these measures fail uterine compression is an option to control bleeding. We present a case where this management was employed. Case A patient presented at 36 weeks of gestation with multiple injuries after a motor vehicle collision and experienced disseminated intravascular coagulation (DIC). The use of a Bakri balloon in combination with external compression with Coban, a sterile self-adherent bandage, after delivery temporized her bleeding and allowed her to become stable for further management. Conclusion When other measures fail and a hysterectomy is considered unsafe, the combination of internal and external uterine compression is an option.

Keywords: disseminated intravascular coagulation; pregnancy; trauma; uterine compression.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
CT of the pregnant uterus, note the fetal skull fracture (small arrow) and likely placental abruption (large arrow). CT, computed tomography.
Fig. 2
Fig. 2
Uterus with VICRYL (polyglactin 910) woven mesh (not seen as it is the internal layer) and Coban sterile adherent bandage used to wrap.
Fig. 3
Fig. 3
MRI abdomen and pelvis on postoperative day 24, revealing myometrial necrosis demonstrated by lack of filling with contrast (arrow). MRI, magnetic resonance imaging.
See this image and copyright information in PMC

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