Accreta Ready: Mastering Abdominopelvic Packing for Crisis Situations

Area of Science:

• Obstetrics and Gynecology
• Surgical Management
• Hemorrhage Control

Background:

• Patients with placenta accreta spectrum undergoing cesarean hysterectomy face a high risk of catastrophic hemorrhage.
• Refractory coagulopathy can complicate obstetric surgery, necessitating advanced management strategies.

Purpose of the Study:

• To familiarize obstetrician-gynecologists with abdominopelvic packing as a lifesaving technique.
• To introduce a novel, low-cost simulation for training in abdominopelvic packing.

Main Methods:

• Abdominopelvic packing involves protecting the bowel, pressure-packing the peritoneal cavity with sponges, and creating negative pressure with drains.
• A low-fidelity, low-cost simulation model was developed to train surgeons in this technique.

Main Results:

• Abdominopelvic packing is presented as a critical intervention for managing severe hemorrhage and coagulopathy.
• The developed simulation effectively demonstrates the steps of abdominopelvic packing.

Conclusions:

• Abdominopelvic packing is an essential skill for obstetrician-gynecologists managing high-risk surgical cases.
• Simulation training can enhance preparedness for managing catastrophic obstetric hemorrhage.