ABSTRAK Latar BelakangPerdarahan pascasalin adalah penyebab 25% kematian ibu diseluruh dunia,bahkan mencapai 60% pada beberapa negara. Sekitar 60-90% disebabkan olehatonia uteri. Berbagai alat ditemukan dan digunakan seperti tamponade balonuterus, NASG (Nonpneumatic Anti Shock Garment), Bakri Balloon dan TheGlenveigh Medical Complete Tamponade System namun memiliki efektifitassekitar 65-87,5% dan potensi komplikasi. Oleh sebab itu diperkenalkanlah suatumetode baru untuk mengontrol perdarahan pascasalin. MetodeTujuan dari penelitian ini adalah untuk melihat keamanan, kemudahan danefektifitas alat InPress mengatasi perdarahan pascasalin karena atonia uteri. AlatInPress menggunakan mesin vakum bertekanan rendah untuk menurunkantekanan atmosfer dalam kavum uteri sehingga uterus menjadi kolaps danmembuat tamponade sehingga perdarahan berhenti. Selain itu secara fisiologis,dapat merangsang kontraksi uterus pascasalin yang normal dan retraksi uterus kebentuk dan ukuran semula. HasilDari sepuluh subyek penelitian menunjukkan bahwa mesin vakum dengan cepatmenciptakan tamponade yang efektif melalui balon pengunci yang berada diostium uteri eksterna. Jumlah perdarahan yang dievakuasi dari kavum uteri sekitar100-250 cc, tertampung dalam kanister. Uterus kolaps dan terjadi tamponadedalam waktu 1-2 menit sehingga perdarahan berhenti. Alat InPress dipasangselama minimal 1 jam dan maksimal 6,5 jam. Repair luka robekan perineum danvagina dapat dilakukan dengan mudah saat alat InPress terpasang di dalam uterus.Pada sepuluh subyek tidak ada tindakan lanjutan untuk mengatasi perdarahansetelah alat InPress dipasang. Tidak ditemukan adanya kelainan pada uterus,serviks dan vagina pada saat dan sesudah pemasangan alat InPress. KesimpulanTamponade uterus yang berasal dari tekanan negatif mesin vakum terbukti aman dan efektif untuk mengatasi perdarahan pascasalin karena atonia uteri.ABSTRACT Background the Treatment of Postpartum Hemorrhage Due To UterineAtonia Postpartum Hemorrhage (PPH) is responsible for +/- 25% of maternal mortalityworldwide, reaching as high as 60% in some countries. Approximately 60-90%caused by uterine atonia. Many devices were invented and applied such as uterineballoon tamponade, NASG (Nonpneumatic Anti Shock Garment), Bakri Balloondan The Glenveigh Medical Complete Tamponade System but the effectivenessonly about 65-87,5% control hemorrhage and have potential complications.Therefor a new method to control PPH has been introduced. MethodThe purpose of this study was to demonstrate patient safety, device efficiency, andease of use, as an overall Proof of Concept with a new device, the InPress Device,for the treatment of primary postpartum hemorrhage (PPH) due to atony.The InPress device uses gentle vacuum force to lower the atmospheric pressurewithin the uterine cavity to collapse the uterus into and onto itself to stophemorrhage through tamponade. It also stimulates normal postpartum uterinecontractions, to effect hemostasis. In this hemostatic state the atonic uterusrecovers, physiologically, and retracts down to its? normal hemostatic postpartumsize. Results Results from our ten trial patients showed that: the vacuum created an immediateeffective tamponade confined to the uterus by our seal situated at the externalcervical ostium, 100-250 milliliters of residual blood were evacuated from theuterine cavity into the vacuum canister. The uterus collapsed and regained tonewithin 1-2 minutes, and hemorrhaging stopped, in all cases. The device stayed inplace while vaginal and perineal lacerations, which occurred during delivery, wereeasily repaired. The device was left in for one-hour minimum up to 6,5 hours. There were no further operative procedures required to stop hemorrhaging in anyof these cases. There was no abnormality of uterus, cervix and vagina while andafter InPress procedur performed. Conclusion Vacuum induced uterine tamponade using physiologic force, is a safe andeffective way to achieve rapid control of PPH due to atony.;Background the Treatment of Postpartum Hemorrhage Due To UterineAtonia Postpartum Hemorrhage (PPH) is responsible for +/- 25% of maternal mortalityworldwide, reaching as high as 60% in some countries. Approximately 60-90%caused by uterine atonia. Many devices were invented and applied such as uterineballoon tamponade, NASG (Nonpneumatic Anti Shock Garment), Bakri Balloondan The Glenveigh Medical Complete Tamponade System but the effectivenessonly about 65-87,5% control hemorrhage and have potential complications.Therefor a new method to control PPH has been introduced. MethodThe purpose of this study was to demonstrate patient safety, device efficiency, andease of use, as an overall Proof of Concept with a new device, the InPress Device,for the treatment of primary postpartum hemorrhage (PPH) due to atony.The InPress device uses gentle vacuum force to lower the atmospheric pressurewithin the uterine cavity to collapse the uterus into and onto itself to stophemorrhage through tamponade. It also stimulates normal postpartum uterinecontractions, to effect hemostasis. In this hemostatic state the atonic uterusrecovers, physiologically, and retracts down to its? normal hemostatic postpartumsize. Results Results from our ten trial patients showed that: the vacuum created an immediateeffective tamponade confined to the uterus by our seal situated at the externalcervical ostium, 100-250 milliliters of residual blood were evacuated from theuterine cavity into the vacuum canister. The uterus collapsed and regained tonewithin 1-2 minutes, and hemorrhaging stopped, in all cases. The device stayed inplace while vaginal and perineal lacerations, which occurred during delivery, wereeasily repaired. The device was left in for one-hour minimum up to 6,5 hours. There were no further operative procedures required to stop hemorrhaging in anyof these cases. There was no abnormality of uterus, cervix and vagina while andafter InPress procedur performed. Conclusion Vacuum induced uterine tamponade using physiologic force, is a safe andeffective way to achieve rapid control of PPH due to atony.;Background the Treatment of Postpartum Hemorrhage Due To UterineAtonia Postpartum Hemorrhage (PPH) is responsible for +/- 25% of maternal mortalityworldwide, reaching as high as 60% in some countries. Approximately 60-90%caused by uterine atonia. Many devices were invented and applied such as uterineballoon tamponade, NASG (Nonpneumatic Anti Shock Garment), Bakri Balloondan The Glenveigh Medical Complete Tamponade System but the effectivenessonly about 65-87,5% control hemorrhage and have potential complications.Therefor a new method to control PPH has been introduced. MethodThe purpose of this study was to demonstrate patient safety, device efficiency, andease of use, as an overall Proof of Concept with a new device, the InPress Device,for the treatment of primary postpartum hemorrhage (PPH) due to atony.The InPress device uses gentle vacuum force to lower the atmospheric pressurewithin the uterine cavity to collapse the uterus into and onto itself to stophemorrhage through tamponade. It also stimulates normal postpartum uterinecontractions, to effect hemostasis. In this hemostatic state the atonic uterusrecovers, physiologically, and retracts down to its? normal hemostatic postpartumsize. Results Results from our ten trial patients showed that: the vacuum created an immediateeffective tamponade confined to the uterus by our seal situated at the externalcervical ostium, 100-250 milliliters of residual blood were evacuated from theuterine cavity into the vacuum canister. The uterus collapsed and regained tonewithin 1-2 minutes, and hemorrhaging stopped, in all cases. The device stayed inplace while vaginal and perineal lacerations, which occurred during delivery, wereeasily repaired. The device was left in for one-hour minimum up to 6,5 hours. There were no further operative procedures required to stop hemorrhaging in anyof these cases. There was no abnormality of uterus, cervix and vagina while andafter InPress procedur performed. Conclusion Vacuum induced uterine tamponade using physiologic force, is a safe andeffective way to achieve rapid control of PPH due to atony. |