Successful use of Sengstaken-Blakemore tube to control massive postpartum haemorrhage
Article first published online: 19 AUG 2005
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 101, Issue 11, pages 1023–1024, November 1994
How to Cite
Condie, R. G., Buxton, E. J. and Payne, E. S. (1994), Successful use of Sengstaken-Blakemore tube to control massive postpartum haemorrhage. BJOG: An International Journal of Obstetrics & Gynaecology, 101: 1023–1024. doi: 10.1111/j.1471-0528.1994.tb13058.x
- Issue published online: 19 AUG 2005
- Article first published online: 19 AUG 2005
We write following the case report by Katesmark, Brown and Raju (March 101, 1994) describing the successful use of a Sengstaken-Blakemore tube to control postpartum haemorrhage. We were interested to hear the description of the use of such tubes in a fairly wide variety of situations and describe its use in a case of vaginal lacerations with intractable haemorrhage.
A 14 year old girl of Afro-Carribean origin was admitted through the Accident & Emergency department; she was shocked after a massive vaginal haemorrhage. Her mother reported that the injury had been inflicted by a boyfriend of 15 years of age. The girl was taken quickly to the operating theatre for examination under anaesthetic where it was discovered that she had multiple vaginal lacerations going up into the posterior fornix; there were a number of arterial bleeding points identified. After resuscitation and a blood transfusion of four units the vaginal lacerations were sutured after ligating arterial bleeders and a vaginal pack was inserted.
Four hours later severe recurrent vaginal haemorrhage was noted and the girl was taken for another examination under anaesthetic when another pack was inserted after re-suturing. Four hours later there was a further haemorrhage and she required another six units of blood. Clotting studies, however, remained normal throughout. She was again returned to theatre when vigorous attempts at haemostasis again failed and a laparotomy was carried out. Both broad ligaments were affected by haematomata and were dissected. No arterial bleeders were identified and both right and left anterior divisions of the internal iliac arteries were ligated. Unfortunately, the vaginal bleeding continued and, in desperation, it was decided to apply a Sengstaken tube. This was inserted into the vagina where the balloon and long tubes were inflated. Haemostasis was largely effected, and she was transferred to the intensive care unit for 24 hours observation.
A total of 16 units of blood were transfused and the girl made an uneventful recovery, although 10 hours after the event the Sengstaken tube was expelled from the vagina. There was no further bleeding and the patient was discharged four days later. We feel that it would be of interest for readers to know of this somewhat unusual, but life-saving, use of a Sengstaken tube.