Uterine packing in the management of complete placenta praeuvia.

BACKGROUND

Complete (type 4) placenta praevia is a major cause of haemorrhage in Obstetrics. Uterine packing is an effective but underutilized life-saving intervention in situation of uncontrolled haemorrahage due to major placenta praevia.

OBJECTIVES

To reappraise the effectiveness of uterine packing in the management of complete placenta praevia in order to popularize the practice.

METHODS

Seven case series of complete placenta praevia were managed with uterine packing in Enugu, Nigeria between January 2, 2012 and February 28, 2013.

RESULTS AND INTERPRETATION: Previous Caesarean delivery (85.71%) was the commonest identified risk factor for complete placenta praevia. Uterine packing was effective in preventing blood transfusion in 57.14% of the cases, and further post-operative intervention in 85.71%.Peripartum hysterectomy and maternal death were 100% avoidable.

CONCLUSIONS

Uterine packing is an effective life-saving intervention in management of complete placenta praevia. The technique should be considered whenever there is uncontrollable haemorrage following complete placenta praevia.