[Intrauterine tamponade: Practices and training assessment]

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Surgical Techniques

Background:

• Postpartum hemorrhage (PPH) remains a significant cause of maternal morbidity and mortality worldwide.
• Intrauterine tamponade (IUT) is a recognized conservative management strategy for PPH.
• Understanding current practices and resident training in IUT is crucial for optimizing PPH management.

Purpose of the Study:

• To delineate the current practices of intrauterine tamponade (IUT) utilization across French centers.
• To assess the adequacy and perceived effectiveness of resident training in IUT procedures.

Main Methods:

• A nationwide anonymous survey was distributed to obstetrics and gynecology residents in France (May 2018 - July 2019).
• Data collected included center-specific IUT practices (delivery mode, insertion, ultrasound, adjuncts) and resident training experiences (frequency, methods, challenges).
• First-year residents' responses were excluded to focus on more experienced trainees.

Main Results:

• 145 responses were received, representing 27 out of 28 French regions, indicating widespread IUT use.
• All surveyed centers employ IUT for both cesarean sections and vaginal deliveries.
• Vaginal gauze and antibiotic prophylaxis were used in 74% and 65% of cases, respectively; however, only 26% of residents reported specific IUT training, and 21% had never performed an IUT.

Conclusions:

• Intrauterine tamponade is a widely adopted technique in France for managing PPH, irrespective of delivery mode.
• There is a notable gap in structured resident training for IUT, with a significant proportion of residents lacking practical experience.
• Simulation-based training is highly recommended to enhance resident competency in intrauterine tamponade techniques.