Bibliographic information
GuidelineConsolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
New
Uterine packing with plain gauze or gauze impregnated with haemostatic agent(s) is not recommended for the treatment of postpartum haemorrhage
Not recommended
Notes and Remarks
- On reviewing the available evidence, the GDG agreed that there is currently insufficient evidence to support the use of any form of uterine packing, whether with plain gauze or gauze impregnated with haemostatic agents, for the treatment of PPH.
- Uterine packing may delay escalation to other definitive interventions for PPH that have demonstrable evidence of benefit, thereby increasing the risk of adverse outcomes.
- The GDG recognizes that uterine packing may be useful as a temporizing measure when all medical treatment has failed in contexts where no other interventions for treating PPH are available. Priority should be placed on urgently transferring the woman to higher-level care where definitive life-saving interventions can be administered.
- Well-designed, prospective controlled studies are needed to assess the safety, effectiveness and potential added value of uterine packing, whether with plain gauze or gauze impregnated with haemostatic agents, when used in addition to or as a substitute for currently recommended non-surgical interventions for refractory PPH. Comparative research evaluating uterine packing against recommended interventions, such as uterine balloon tamponade or other conservative options, would be particularly valuable.