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Case Reports
. 2024 Oct 8;16(10):e71079.
doi: 10.7759/cureus.71079. eCollection 2024 Oct.

Chitosan Gauze in the Management of Acute Postpartum Hemorrhage in a Mexican Third-Level Institution: A Case Report

Roberto Velasco Sordo  1 , Humberto López Maldonado  1 , Daniel A Ramirez Flores  1 , Eduardo Ibarrola Buen Abad  1 , Pablo Vilchis Nava  1
Affiliations
Case Reports

Chitosan Gauze in the Management of Acute Postpartum Hemorrhage in a Mexican Third-Level Institution: A Case Report

Roberto Velasco Sordo et al. Cureus. .

Abstract

Obstetric hemorrhage is the main cause of maternal death worldwide; over the years, its management has been based on uterotonic drugs as well as definitive and non-definitive surgical techniques. We report the case of a patient with multiple risk factors for obstetric hemorrhage who was given the classic management for postpartum hemorrhage before the addition of chitosan gauze, which resulted in adequate remission of the condition. The patient had an adequate in-hospital evolution; the chitosan gauze was removed after 24 hours, and she was discharged after 48 hours without active bleeding. When identifying women at high risk of obstetric hemorrhage, having chitosan gauze in the operating room could be a point of good care.

Keywords: chitosan gauze; hysterectomy; intrauterine balloon tamponade; obstetric complications; postpartum hemorrhage; uterine packing.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Abdominal ultrasound examination 18 hours post-delivery.
blue arrow: uterine fundus; red arrow: chitosan gauze; green arrow: acoustic shadow
Figure 2
Figure 2. Abdominal control ultrasound.
blue arrows: clean endometrial lining; green arrow: uterine fundus
Figure 3
Figure 3. Molecular synthesis of chitosan.
Image credit: Humberto López Maldonado
Figure 4
Figure 4. Schematic representation of chitosan gauze packing vs. Bakri balloon.
One of the main advantages of chitosan gauze compared to the Bakri balloon is that it occupies the entire uterine cavity, leaving no space in the uterine fundus. Image credit: Humberto López Maldonado
See this image and copyright information in PMC

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