Uterus wrapping-bandage compression to counteract uterine atony during cesarean section

BackgroundUterine atony during cesarean delivery is aserious cause of maternal morbidity and mortality. Management strategies include medical treatment with uterotonic agents, compression maneuvers of the uterus, and interventional or surgical procedures.ObjectiveIntroduction of an alternative concept of external uterine compression in cases of atony during cesarean section.Materials and methodsAs an alternative to the standard manual external compression of the uterus in cases of atony during caesarean section, the uterus can be compressed by wrapping it with an elastic bandage.ResultsThe experiences with uterus wrapping in our center are highly positive. No complications were seen after performing uterus wrapping. However, only case series exist and no randomized prospective study is available.ConclusionThe method of intermittent wrapping of the uterus during caesarean section seems to be asuccessful additional approach in the management of uterine atony. It may be an alternative or additional treatment option to other procedures in order to avoid high blood loss, gain time until uterotonic drugs take their effect, and thereby perhaps avoid postpartum hysterectomy.