Modified abdominal packing method in "near miss" patients with postpartum hemorrhages

Turk J Obstet Gynecol. 2018 Sep;15(3):159-164. doi: 10.4274/tjod.79095. Epub 2018 Sep 3.


Objective: To describe a more effective abdominal packing method in patients with disseminated intravascular coagulation following peripartum hysterectomy due to postpartum hemorrhage (PPH).

Materials and methods: The present retrospective and descriptive study was conducted to document six cases with refractory pelvic bleeding who underwent a second surgery for PPH between January 2016 and December 2017 at İstanbul Zeynep Kamil Woman and Children Diseases Training and Research Hospital.

Results: Karateke packing was performed to control intra-abdominal massive hemorrhages of five women who were referred to our clinic due to PPH who had undergone peripartum hysterectomy and hypogastric artery ligation but hemostasis could not be provided. In addition, a case of hypovolemic shock due to placenta percreta rupture in a woman who had also undergone an emergency hysterectomy and hypogastric artery ligation, which had failed. Hemostasis was provided in all patients. No method-related complication developed.

Conclusion: Karateke packing is a very easy method to perform, it is more effective than the classic abdominal packing technique, with a low complication rate, and most importantly, life-saving in patients undergoing a peripartum hysterectomy due to PPH and thereafter experiencing diffuse hemorrhage.

Keywords: Abdominal packing; near miss; peripartum hysterectomy.