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. 2020 Nov;136(5):876-881.
doi: 10.1097/AOG.0000000000004135.

Management of Postpartum Hemorrhage With a Mini-Sponge Tamponade Device

Maria I Rodriguez  1 , Mary Bullard, Jeffrey T Jensen, Kenton Gregory, Bellington Vwalika, Andrew D Barofsky, Tola Marts, Alison B Edelman
Affiliations

Management of Postpartum Hemorrhage With a Mini-Sponge Tamponade Device

Maria I Rodriguez et al. Obstet Gynecol. 2020 Nov.

Abstract

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.

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Figures

Fig. 1.
Fig. 1.. The study device is composed of a mini-sponge pouch that is delivered with a curved applicator and plunger. Image courtesy of OBSTETRX. Used with permission.
Rodriguez. Mini Sponge Device for Uterine Tamponade. Obstet Gynecol 2020.
Fig. 2.
Fig. 2.. Placement and removal of study device. The applicator is inserted through the vagina into the lower uterine segment. A. The plunger is depressed, ejecting the mini-sponge pouch into the uterus. B. The applicator is gently removed from the uterus, and the removal strand is left in the vaginal canal. Once inside the uterus, the mini-sponges absorb blood and pack the uterus. C. When the patient is clinically stable and it is deemed safe to remove the dressing, the pouch is removed by applying gentle, steady traction to the removal strand. Images courtesy of OBSTETRX. Used with permission.
Rodriguez. Mini Sponge Device for Uterine Tamponade. Obstet Gynecol 2020.
Fig. 3.
Fig. 3.. Study enrollment chart. Image courtesy of OBSTETRX. Modified with permission.
Rodriguez. Mini Sponge Device for Uterine Tamponade. Obstet Gynecol 2020.
Fig. 4.
Fig. 4.. Ultrasound images of device within uterus. Sagittal view (A) and longitudinal view (B). Images courtesy of OBSTETRX. Used with permission.
Rodriguez. Mini Sponge Device for Uterine Tamponade. Obstet Gynecol 2020.
Figure
Figure
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References

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