Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage

Bernd C. Schmid, Günther A. Rezniczek, Norbert Rolf, George Saade, Gerhard Gebauer, Holger Maul

Research output: Contribution to journalArticle

23 Citations (Scopus)

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.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume209
Issue number3
DOIs
StatePublished - Sep 2013

Fingerprint

Postpartum Hemorrhage
Chitosan
Placenta Accreta
Hysterectomy
Uterine Inertia
Hysterotomy
Peripartum Period
Chitin
Hemostatics
Therapeutics
Odds Ratio
Parturition
Hemorrhage

Keywords

  • chitosan
  • postpartum hemorrhage
  • utero-vaginal packing

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage. / Schmid, Bernd C.; Rezniczek, Günther A.; Rolf, Norbert; Saade, George; Gebauer, Gerhard; Maul, Holger.

In: American Journal of Obstetrics and Gynecology, Vol. 209, No. 3, 09.2013.

Research output: Contribution to journalArticle

Schmid, Bernd C. ; Rezniczek, Günther A. ; Rolf, Norbert ; Saade, George ; Gebauer, Gerhard ; Maul, Holger. / Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage. In: American Journal of Obstetrics and Gynecology. 2013 ; Vol. 209, No. 3.
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