Uterine rupture successfully treated with a damage‐control strategy of hysterectomy and resuscitative endovascular balloon occlusion of the aorta‐assisted cardiopulmonary resuscitation

Abstract

Abstract Background Uterine rupture is a major cause of postpartum hemorrhage (PPH) that requires surgery. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is also helpful for PPH. However, the effectiveness of REBOA in PPH with cardiac arrest is unknown. Case Presentation A 40‐year‐old woman developed hemorrhagic shock due to uterine rupture after an induced delivery. She developed cardiac arrest, but was rescued by cardiopulmonary resuscitation (CPR), REBOA, a hysterectomy, and pelvic gauze packing. The hemodynamics were too unstable to move to the operating room. Then we initiated the CPR assisted with REBOA and decided to activate massive transfusion and perform laparotomy in the emergency room. She was finally discharged home without neurological sequelae. Conclusion Our damage control strategy, including REBOA‐assisted CPR, contributed to saving the life of a patient with a life‐threatening PPH.

Keywords

• damage control
• disseminated intravascular coagulation
• postpartum hemorrhage
• resuscitative endovascular balloon occlusion of the aorta
• uterine rupture