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. 2021 May;80(5):104-107.

Constructing a Novel 'Uterine Sandwich' with Simultaneous Intrauterine Balloon Tamponade and Uterine Compression Sutures to Manage Postpartum Bleeding

Jennifer W H Wong  1 , Grace K Wong  2
Affiliations

Constructing a Novel 'Uterine Sandwich' with Simultaneous Intrauterine Balloon Tamponade and Uterine Compression Sutures to Manage Postpartum Bleeding

Jennifer W H Wong et al. Hawaii J Health Soc Welf. 2021 May.

Abstract

The uterine sandwich is a relatively new surgical technique for managing postpartum hemorrhage, which is the leading cause of maternal mortality worldwide. The purpose of this case series is to describe a novel method of constructing the uterine sandwich by simultaneously combining intrauterine balloon tamponade and uterine compression sutures. Six patients with postpartum bleeding refractory to medical management were successfully treated with this novel method and avoided hysterectomy. There were no additional complications. This novel method of constructing a uterine sandwich appears to be a simple, safe, and effective technique that could be considered in cases of persistent postpartum bleeding. More research is needed to compare the efficacy of various techniques.

Keywords: obstetrics; postpartum hemorrhage; uterine atony.

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Figures

Figure 1.
Figure 1.
How to Construct a Uterine Sandwich by Simultaneously Combining Intrauterine Balloon Tamponade and Uterine Compression Sutures. A: Exteriorize the uterus, close the hysterotomy, and place modified B-Lynch sutures without tying the sutures. B: Return the uterus into the abdomen, insert the Bakri balloon via the vagina, and inflate the Bakri balloon. C: Cinched down and tie the B-Lynch sutures.
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