Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/93273
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Type: Journal article
Title: Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage
Author: Schmid, B.
Rezniczek, G.
Rolf, N.
Saade, G.
Gebauer, G.
Maul, H.
Citation: American Journal of Obstetrics and Gynecology, 2013; 209(3):225.e1-225.e5
Publisher: Elsevier
Issue Date: 2013
ISSN: 0002-9378
1097-6868
Statement of
Responsibility: 
Bernd C. Schmid, Günther A. Rezniczek, Norbert Rolf, George Saade, Gerhard Gebauer, Holger Maul
Abstract: OBJECTIVE: To describe the use of gauze covered with chitosan, a potent hemostatic agent derived from chitin, in the treatment of postpartum hemorrhage (PPH). STUDY DESIGN: Patients suffering from postpartum hemorrhage were treated by uterine packing with chitosan-covered gauze, either through the hysterotomy in case of cesarean delivery or transvaginally, for up to 24 hours. RESULTS: Chitosan-covered gauze was used in 19 cases of postpartum hemorrhage due to uterine atony, placenta accreta/increta, or anticoagulation, including 5 severe cases where a hysterectomy seemed inevitable otherwise. In all but one case, the bleeding stopped and further interventions were avoided. Over comparable periods of time (18 months) and births (3822 vs 4077) before and after the introduction of the chitosan gauze in our clinic, the rate of peripartum hysterectomies was reduced by 75% (8 vs 2; odds ratio, 4.27; P = .044). CONCLUSION: Chitosan-covered gauze is a viable option in the treatment of (severe) postpartum hemorrhage. It is easy to use and requires no special training. It can be used after both vaginal and cesarean deliveries, and there are no adverse side effects. Furthermore, it is very inexpensive compared with other treatment options, making it suitable for use also in low resource-countries, where the death toll due to postpartum hemorrhage is especially high.
Keywords: Postpartum Hemorrhage
Rights: © 2013 Mosby, Inc. All rights reserved.
RMID: 0030024606
DOI: 10.1016/j.ajog.2013.05.055
Appears in Collections:Obstetrics and Gynaecology publications

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