Angiographic findings after vaginal gauze packing: New insight into an old technique

Shinsuke Koyama1, Munehiro Maeda, Masaki Kobayashi

  • 1Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Sakai, Osaka, Japan. syokama@gyne.med.osaka-u.ac.jp

We had a transferred case of cervical ectopic pregnancy with hemorrhagic shock at 6 weeks of gestation. Upon arrival at hospital, we performed tight and full vaginal gauze packing to push the uterus upward to control the patient's hemorrhage. Following stabilization of her general condition, she was treated with uterine artery embolization. Using angiography, the effectiveness of vaginal gauze packing for emergency hemostasis by the presumed mechanism of impairing blood flow through the uterine artery was demonstrated. To our knowledge, there are no reports that have previously demonstrated angiographic findings similar to ours after vaginal gauze packing. Vaginal gauze packing is an effective, rapid, and convenient hemostatic procedure able to be carried out in a time-sensitive and challenging situation. As a result, this procedure gives clinicians more time to improve the patients' general status and arrange for transfusion and further definitive treatment.