Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage

Schmid, Bernd; Rezniczek, Günther A.; Rolf, Norbert; Saade, George R.; Gebauer, Gerhard; Maul, Holger

doi:10.1016/j.ajog.2013.05.055

Cited by 57 publications

(35 citation statements)

References 13 publications

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“…Schmid and colleagues (2013) used chitosan-impregnated gauze as uterine packing in 19 consecutive cases of post-partum hemorrhage following vaginal (n=8) or cesarean (n=11) delivery. Rate of hysterectomy was reduced by 75% relative to an equivalent time period prior to the introduction of the product, and no adverse side effects were noted [40]. Quikclot® (Z-Medica, Wallingford, CT) is a chelating agent consisting of aluminum silicate which concentrates clotting factors and platelets.…”

Section: Comparison To Other Topical Hemostatic Agentsmentioning

confidence: 99%

Use of Monsel solution to treat obstetrical hemorrhage: a review and comparison to other topical hemostatic agents

Miller

Roque

Santin

2015

American Journal of Obstetrics and Gynecology

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Peripartum hemorrhage accounts for 8% of maternal deaths in the United States, and nearly 27% worldwide. A growing need exists for tactics to spare morbidity given a rise of abnormal placentation that contributes to excessive blood loss at the time of delivery. Approaches such as compression sutures, balloon tamponade, and pelvic artery embolization are not without side effects and potential implications for future fertility. The use of topical hemostatic agents has become widespread in gynecologic and obstetric surgery despite a paucity of distinct studies in the field, and may allow providers to increasingly avoid cesarean hysterectomy. A variety of topical hemostatic agents exist along a wide cost continuum, each characterized by specific efficacy, advantages, drawbacks, and often gaps in long-term data to support safety and impact on future fertility. Herein, we comprehensively review these agents and illustrate a non-traditional use of Monsel’s solution applied directly to the placental bed in a case of focal placenta accreta. This ultimately contributed to successful uterine preservation with no known adverse sequelae. Monsel’s solution may have a role in establishing hemostasis in the setting of abnormal placentation, and may be a particularly attractive alternative in resource-poor nations.

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Section: Comparison To Other Topical Hemostatic Agentsmentioning

confidence: 99%

Use of Monsel solution to treat obstetrical hemorrhage: a review and comparison to other topical hemostatic agents

Miller

Roque

Santin

2015

American Journal of Obstetrics and Gynecology

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“…The group of Schmid et al 4 obtained good results for uterovaginal packing with chitosan in 18 of 19 cases. The rate of hysterectomy in this department has decreased by 75% in 18 months (OR 4.27; p=0.044).…”

mentioning

confidence: 95%

“…In 2012 and 2013, Schmid et al reported the first case of the successful use of chitosan-coated gauze to treat severe PPH. 3,4 We report here three cases of the use of chitosan to treat life-threatening obstetric bleeding.…”

Section: Introductionmentioning

confidence: 99%

Different Uses of Chitosan for Treating Serious Obstetric Hemorrhages

Carles¹,

Dabiri²,

Mchirgui³

et al. 2016

Gynecol Obstet Res Open J

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“…In addition to medical treatment by uterotonic agents, manual compression/massage of the uterus and interventional or surgical procedures are performed [1]. Those procedures include embolization of the uterine artery, uterine packing with gauze [2], uterine compression sutures [3–7], tamponade of the uterus by application of a balloon [8], bilateral arcuate artery suture [9], and ligation of the uterine artery. The aim of all these treatment options is to reduce blood loss and to avoid hysterectomy in order to sustain maternal fertility.…”

Section: Introductionmentioning

confidence: 99%

Uterus Wrapping: A Novel Concept in the Management of Uterine Atony during Cesarean Delivery

Kimmich

Engel

Kreft

et al. 2015

Case Reports in Obstetrics and Gynecology

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Uterine atony during cesarean delivery is a serious cause of maternal morbidity and mortality. Management strategies include medical treatment with uterotonic agents, manual compression of the uterus, and interventional or surgical procedures. A novel technique to compress the uterus by wrapping it with an elastic bandage and its outcome in 3 cases of uterine atony during cesarean section are presented. Our novel method of intermittent wrapping of the uterus during cesarean delivery seems to be a successful additional approach in the management of uterine atony during cesarean delivery and may be an alternative treatment option to other compressing procedures in order to avoid high blood loss and last but not least postpartum hysterectomy.

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Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage

Cited by 57 publications

References 13 publications

Use of Monsel solution to treat obstetrical hemorrhage: a review and comparison to other topical hemostatic agents

Use of Monsel solution to treat obstetrical hemorrhage: a review and comparison to other topical hemostatic agents

Different Uses of Chitosan for Treating Serious Obstetric Hemorrhages

Uterus Wrapping: A Novel Concept in the Management of Uterine Atony during Cesarean Delivery

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