Indonesian Journal of Perinatology
Vol. 7 No. 1 (2026): Available online: 1 June 2026

Abdominal Packing for Management of Refractory Postpartum Hemorrhage

I Gde Sastra Winata Winata (Department of Obstetrics and Gynecology, Onco-Gynecology Division, Ngoerah Hospital, Denpasar, Bali, Indonesia)
Belinda Carlisa (Department of Obstetrics and Gynecology, Faculty of Medicine, Udayana University/Ngoerah Hospital, Denpasar, Bali, Indonesia)
Jessica Nathalia (Department of Obstetrics and Gynecology, Onco-Gynecology Division, Ngoerah Hospital, Denpasar, Bali, Indonesia)
Ni Nyoman Trijayanti (Master of Public Health, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia)



Article Info

Publish Date
22 Apr 2026

Abstract

Changes in the demographic and clinical characteristics of pregnant women increase the risk of postpartum hemorrhage, which remains one of the leading causes of maternal mortality in Indonesia. Management of severe postpartum hemorrhage may include abdominal packing. This procedure is performed using a balloon tamponade system combined with gauze-based packing. The fundamental principle of balloon tamponade involves the strategic placement of the tampon within the true pelvis (below the pelvic brim), rather than the false pelvis (above the pelvic brim), to achieve direct physical compression against the pelvic bony boundaries. Following the procedure, patients must be closely monitored, and abdominal tampon removal should be performed in a timely manner, typically within 24–48 hours. Complications associated with abdominal packing may occur if sustained intra-abdominal pressure exceeds 20 mmHg, which can lead to organ failure and necessitate abdominal decompression. However, with adequate monitoring and careful implementation, abdominal packing can serve as a safe and effective alternative for the management of refractory postpartum hemorrhage.

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Journal Info

Abbrev

InaJPerinatol

Publisher

Subject

Health Professions Medicine & Pharmacology Nursing

Description

peer-reviewed journal aiming to communicate high-quality research articles, reviews, and general articles in the field. InaJPerinatol publishes articles that encompass basic research/clinical studies related to the cardiovascular and thorax field. The Journal aims to bridge and integrate the ...