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Assessment of a Simulation Training Exercise to Teach Intrauterine Tamponade for the Treatment of Postpartum Hemorrhage


  • Michael L. Stitely MD,

  • Lena Cerbone CNM, MSN,

  • Angelita Nixon CNM, MSN,

  • Jay J. Bringman MD

Michael L. Stitely, MD, West Virginia University School of Medicine, Department of Obstetrics and Gynecology, 1 Medical Center Drive, PO Box 9186, Morgantown, WV 26506-9186. E-mail:


Introduction: Postpartum hemorrhage is a common complication of vaginal birth. Few midwives have experience in the performance of procedures to manage hemorrhage that fails to respond to initial management with medications and bimanual compression.

Methods: A simulation model was constructed by using a half-pelvis birth simulator and a hollowed out cantaloupe. Practicing midwives and students participated in a simulation exercise by using uterine packing and placement of a uterine tamponade balloon. Pre-exercise and post-exercise self-assessments were performed. Data were analyzed by using the Wilcoxon matched pairs signed rank test.

Results: A total of 25 learners participated in the training session. All 25 participants showed improvement in their self-assessed competency level for the placement of the Bakri Postpartum Balloon (P < .001), and 24 of 25 showed improvement in self-assessed competency levels for uterine packing (P < .001).

Discussion: An inexpensive simulation model can be used to effectively train midwives to treat postpartum hemorrhage by using methods of exerting direct pressure to the uterine cavity.