Management of large paravaginal hematomas with the Zhukovsky vaginal catheter

Objective To ameliorate the treatment of large paravaginal hematomas postpartum using the Zhukovsky vaginal catheter. Methods A retrospective, controlled study including puerperas with large paravaginal hematomas. To assess the effectiveness of the proposed treatment, a group of patients underwent t...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2023-10, Vol.163 (1), p.148-153
Main Authors: Barinov, Sergey, Di Renzo, Gian Carlo, Kadtsyna, Тatyana, Nadezhina, Еvgenia, Lazareva, Оksana, Kochev, Dmitry
Format: Article
Language:English
Subjects:
hemostasis
labor
obstetric bleeding
paravaginal hematomas
rupture of the vaginal wall
volume of blood loss
Zhukovsky uterine catheter
Zhukovsky vaginal catheter
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Summary:Objective To ameliorate the treatment of large paravaginal hematomas postpartum using the Zhukovsky vaginal catheter. Methods A retrospective, controlled study including puerperas with large paravaginal hematomas. To assess the effectiveness of the proposed treatment, a group of patients underwent traditional obstetric surgery. A second group of puerperas underwent an integrated approach: the surgical stage (pararectal incision) and the application of the Zhukovsky vaginal catheter. The effectiveness of treatment was assessed according to the following criteria: blood loss volume and hospital admission time. Results In total, 30 puerperas were included in the study; 15 in each treatment group. Large paravaginal hematomas were reported most often in primiparas (50.0%), in 36.7% were combined with rupture of the vagina and the cervix, and in 10.0% of cases an episiotomy was performed during delivery. In 40.0% of primiparas, the blood loss volume was more than 1000 mL, whereas in multiparous and in multiple pregnancies, blood loss did not exceed 1000 mL (r = –0.49; P = 0.022). In 25.0% of puerperas with a blood loss of up to 1000 mL there were no obstetric injuries; in the group with a blood loss of more than 1000 mL, 83.3% of patients had obstetric injuries. An integrated approach reduced the blood loss volume (r = –0.22; P = 0.29), compared with the traditional surgery, and reduced the hospital admission time from 12 (11.5; 13.5) days to 9 (7.5; 10.0) days (P 
ISSN:0020-7292
1879-3479
DOI:10.1002/ijgo.14889