Pelvic and vaginal packing for intractable venous obstetric haemorrhage – practical tips for the obstetrician TOG 2014

Question 1

Minimum size of swab for packing in abdominal route

Answer 1

Large 30x30cm as detectable on XRAY
Folded into sandwich rolls

Question 2

Technique of placing pack for abdominal route

Answer 2

Cab place synthetic bowel bad to prevent adhesion to bowel.

Question 3

When to return to theatre to remove pack

Answer 3

< 24 hours
When hypothermia, acidosis and coagulopathy have been corrected

Question 4

When can abdominal compartment syndrome occur?

Answer 4

If raised in intra-abdominal pressure >12mmHf
Do not closed rectus sheets after pelvic packing

Question 5

Techniques for vaginal packing

Answer 5

Can use bakri balloon and stitch labia