Use of a Fascial Prosthesis for Management of Abdominal Compartment Syndrome Secondary to Obstetric Hemorrhage

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 107; no. 2, Part 2 Suppl; pp. 493 - 496
• Main Authors: Kendrick, James E., Leath, Charles A., Melton, Sherry M., Straughn, J Michael
• Format: Journal Article
• Language: English
• Published: New York, NY The American College of Obstetricians and Gynecologists 01-02-2006; Elsevier Science
• Subjects: Abdomen - surgery; Adult; Biological and medical sciences; Cesarean Section - adverse effects; Compartment Syndromes - etiology; Compartment Syndromes - surgery; Delivery. Postpartum. Lactation; Disorders; Fasciotomy; Female; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Postpartum Hemorrhage - etiology; Postpartum Hemorrhage - surgery; Pregnancy; Prostheses and Implants; Human; Abdominal compartment syndrome; Closure; Prosthesis; Cardiovascular disease; Puerperium; Hemorrhage; Obstetrics; Abdomen; Arterial disease; Vascular disease; Case study; Striated muscle disease; Treatment; Surgical decompression; Abdominal wall; Technique; Fascia; Laparotomy
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000168445.41145.7b

BACKGROUND:Massive obstetric hemorrhage can be catastrophic, with considerable maternal morbidity and mortality.
CASE:A 41-year-old term gravida experienced massive postpartum hemorrhage attributed to an amniotic fluid embolism with rapid development of disseminated intravascular coagulation and resultant abdominal compartment syndrome. In this critically ill patient, a fascial prosthesis used for abdominal wall closure was placed to expedite multiple abdominal explorations and packing. Additionally, this device facilitated fascial closure once the abdominal compartment syndrome was resolved.
CONCLUSION:Abdominal compartment syndrome resulting from overwhelming obstetric hemorrhage may necessitate emergent decompressive laparotomy to alleviate increased intra-abdominal pressure and end-organ dysfunction. The fascial prosthesis allows a staged abdominal wall closure to be performed once the abdominal compartment syndrome is resolved.