Introduction: Postpartum or peripartum hemorrhage (PPH) is a major cause of maternal death worldwide. Fertility preserving second stage interventions following uterotonic medications may include compression sutures, uterine balloon tamponade and ligation or embolization of arteries.
Presentation of case: We present a case of PPH where a novel "uterine sandwich" approach (combination of chitosan-covered gauze with intrauterine balloon tamponade) was effectively used to stop further blood loss and prevented more invasive second stage interventions. Furthermore, we present the ultrasonographic image of chitosan-covered gauze in the uterine cavity.
Discussion: Chitosan-covered gauze and intrauterine balloon tamponade are complementary in their mechanism of work, the balloon reducing blood flow into the uterus and the chitosan-covered gauze enhancing the coagulation.
Conclusion: This novel "uterine sandwich" approach can be a useful method for fertility preserving management of PPH.
Keywords: Chitosan-covered gauze; Intrauterine balloon tamponade; Obstetric complications; Postpartum hemorrhage.
Copyright © 2018. Published by Elsevier Ltd.