Uterine tamponade for the control of acute uterine bleeding

In the field of obstetrics, uterine packing has been used for many years to control postpartum hemorrhage. The control of acute hemorrhage from the nonpuerperal uterus is more difficult. Historically, curettage has been used, but when this fails, hysterectomy has often been a last resort. We have used a Foley catheter inserted into the uterine cavity in 20 patients for the control of acute, profuse uterine hemorrhage. The procedure was completely successful in 17 patients and partially successful in two patients. Failure to control bleeding occurred in one patient. The procedure requires no special expertise or extraordinary equipment. Anesthesia is not required. The procedure involves filling the uterine cavity and the cervical canal with enough pressure to cause immediate tamponade between the Foley catheter balloon and the semirigid uterine wall. The catheter is left in place from several hours to 2 days, depending on the etiology of the hemorrhage. There were no complications attributable to this form of uterine tamponade.