The Bolbos technique for the management of uncontrollable intra-caesarean uterine bleeding

Abstract

Objective

We describe a new conservative surgical technique for the management of intra-operative post-caesarean bleeding.

Methods

This technique involves the application of ligation sutures to the main branches of the right and left uterine arteries at the level of the lower segment transverse uterine incision and a constriction suture to the lower segment of the posterior uterine wall.

Results

We have used this method in nine cases and it was effective in controlling the bleeding in eight, thus avoiding the need for a more extensive procedure.

Conclusion

If medical management fails to control intra-operative post-caesarean bleeding, conservative surgery or even a caesarean hysterectomy may be required. Our technique is presented as a safe, simple, effective and readily reproducible alternative. Also, its effectiveness can be promptly assessed and if the bleeding persists, another, more complex procedure can be performed.