Maimoona Qadir, Sohail Amir.
To determine the efficacy of uterine packing in management of primary postpartum haemorrhage.
J Saidu Med Col Jan ;7(2):79-82.

BACKGROUND: Primary postpartum haemorrhage has been recognized as a leading etiological factor of maternal mortality and morbidity globally. Uterine packing exerts mechanical pressure on the uterine vascular sinuses and is a quick and safe method of controlling haemorrhage. OBJECTIVE: To determine the efficacy of uterine packing in the management of primary postpartum haemorrhage. MATERIALS AND METHODS: This prospective interventional study was conducted at Gynaecology and Obstetrics department st st of Khyber Teaching Hospital, Peshawar from 1 January 2016 to 31 December 2016. 52 patients were included in study. Inclusion criteria was all women of any age or parity, delivered by any mode of delivery who presented with primary postpartum hemorrhage and were managed with uterine packing. Vital monitoring was done and efficacy was confirmed if bleeding ceased and patient remained haemodynamically stable. Patients were followed for six weeks for any postoperative complication. RESULTS: A total of 52 patients were included. Four age groups were created, 6 (11.5%) fell into <20 years age group, 13 (25%) fell into 21-30 years age range, 22 (42%) were in 31-40 years age range and 11 (21%) were >40 years. 36 (69%) were rural and 16 (30.7%) urban citizens. 19 (6.5%) patients were booked and 33 (63.4%) were unbooked. 7 (13.4%) were primipara, 17 (32.6%) were multipara and 28 (53.8%) were grand multipara. 20 (38.4%) subjects received 1-3units of blood, 22 (42.3%) received 4-5 units and 10 (19.2%) received >5 units of blood. Indications for uterine packing was uterine atony in 26 (50%), placenta previa in 14(26%), placental abruption in 5(10%), coagulopathy in 5 (10%) and placental bed bleeding in 2 (4%) patients. Uterine packing was effective in 44 (85%) and ineffective in 8 (15%) patients. CONCLUSION: Uterine packing is an efficacious method of arresting postpartum hemorrhage in resource poor settings especially for patients with low parity who wants to conserve uterus.

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