uterine gauze tamponade

Intrauterine gauze strips are filled with gauze strips to stimulate the uterine cavity, which stimulates contractions and pressure to stop bleeding. Temporary hemostasis or reduced bleeding can be used when postpartum hemorrhage caused by uterine insufficiency is ineffective. Treatment of diseases: uterine contraction, weakness, placenta previa Indication 1. Uterine contraction caused by postpartum hemorrhage, uterine contractions and other treatment methods are invalid. Vaginal delivery is not commonly used because of its vulnerability to infection, difficulty in tightening, etc. When the cesarean section is placed under direct vision, the gauze is filled and the hemostasis effect is good. 2. When the placenta previa is cesarean section, the contraction of the lower uterus is poor, resulting in massive bleeding, and the uterine contraction and other treatments are ineffective. Contraindications 1. Postpartum hemorrhage caused by factors other than uterine weakness. Such as birth canal damage. Placental residue. Placenta implants. 2. Abnormal coagulation function such as amniotic fluid embolism leads to postpartum hemorrhage, and can not stop bleeding by filling gauze. Preoperative preparation 1. Prepare a sterile gauze strip with a length of 6 m, a width of 5 to 6 cm, and a thickness of 4 to 5. 2. Place the placenta pliers or the oval pliers for disinfection. 3. Give an appropriate amount of sedative. Surgical procedure Vaginal delivery and postpartum hemorrhage during cesarean section can be filled with intravaginal gauze, and the filling method is slightly different. Vaginal filling gauze 1 by hand filling method: one hand on the abdominal wall to fix the uterus body, the other hand palm up, into the uterine cavity, with the middle index finger gauze strip into the uterine cavity, starting from the uterine horn, S-shaped back and forth, Press the sand cloth with four fingers. The entire uterine cavity is filled evenly and firmly from top to bottom, leaving no dead space in the uterine cavity. The end of the gauze segment is in the vagina. 2 device uterine tamponade method: the assistant fixes the uterus bottom on the abdominal wall, the surgeon uses the left hand to extend into the uterine cavity as the guide, and the right hand holding gynecological long curved forceps or sponge clamp to hold the gauze strip to the bottom of the palace, the order of the filling method is the same Finger padding method needs to be filled. 2. Fill the gauze through the incision of the cesarean section. If the bleeding occurs after cesarean section, the gauze should be filled through the cesarean section. The filling also starts from the bottom of the palace, the same way as before. When filling near the incision, estimate the length of gauze required for the remainder based on the length of the lower segment of the uterus. First use the oval clamp to insert the broken end of the gauze from the cervix into the vagina, then fill the gauze from the lower part of the uterus and meet at the incision. Use the absorbable thread to suture the uterine incision, suture from the two ends of the incision to the middle, directly look at each needle and needle, avoid the gauze; sew into the middle, when the gap of the finger is left, use the finger to enter the uterine cavity The sutured incision is probed to determine that the suture is closed after the suture is not sewn into the uterine cavity. After the 1 cloth is stuffed, the uterine contraction agent is injected, and if necessary, the uterine contraction agent is intravenously instilled. 2 Abdominal gentian violet mark the height of the fundus, regular observation of the height of the fundus and vaginal bleeding. 3 Keep the catheter and observe the urine volume regularly. 4 Maintain the venous access and prepare for blood transfusion. 5 monitor body temperature, heart rate, blood pressure, respiratory and other vital signs, conditional units can be ECG monitoring. 6 preventive application of antibiotics to prevent infection. 3. Extract the gauze. complication 1. Postoperative infection. 2. Filling the gauze strip improperly, causing hidden bleeding in the uterine cavity.