Methods for postpartum uterine hemostasis
A method of uterine hemostasis involves inserting a suction line of a postpartum hemorrhage mitigation device through a cesarian incision into the uterine cavity, guiding the suction line through the cervix and into the vagina, positioning an anchoring mechanism of the device adjacent the internal cervical OS of the uterine cavity, closing the cesarian incision to enclose the suction line within the uterine cavity, and connecting the suction line to a negative pressure source that introduces negative pressure to the uterine cavity via the suction line, thereby causing contraction of the uterus and evacuation of fluid from the uterus via the suction line extension. Upon completion of a treatment period, the negative pressure source is disconnected, and the suction line and anchoring mechanism are extracted from the uterus through the cervical canal and the vagina.
1 . A method of uterine hemostasis using a postpartum hemorrhage mitigation device that is configured to be disposed within a uterine cavity of a uterus after childbirth, wherein the postpartum hemorrhage mitigation device includes a suction line and an anchoring mechanism, the suction line having a distal portion and a proximal portion, the proximal portion comprising a suction line extension, wherein the anchoring mechanism is configured to maintain the suction line extension in a desired position within the uterine cavity, the method comprising:
(a) inserting the distal portion of the suction line through a cesarian incision into the uterine cavity;
(b) guiding the distal portion of the suction line through the uterine cavity, into and through the cervix, and into and through the vagina;
(c) positioning the anchoring mechanism adjacent the internal cervical OS of the uterine cavity;
(d) closing the cesarian incision to enclose the proximal portion of the suction line within the uterine cavity;
(e) connecting the distal portion of the suction line to a source of negative pressure, thereby introducing negative pressure to the uterine cavity via the suction line during a treatment period, which causes contraction of the uterus and evacuation of fluid from the uterus via the suction line extension;
(f) upon completion of the treatment period, detaching the suction line from the source of negative pressure; and
(g) extracting the suction line extension and the anchoring mechanism from the uterus by pulling the proximal portion of the suction line through the cervical canal and into the vagina.
2 . The method of claim 1 , wherein the distal portion of the suction line includes a tapered tip, and wherein:
step (a) comprises inserting the tapered tip into through the cesarian incision and into the uterine cavity;
step (b) comprises guiding the tapered tip through the uterine cavity, into and through the cervical canal, and into and through the vagina; and
step (e) comprises removing the tapered tip from the distal portion of the suction line before connecting the distal portion of the suction line to the source of negative pressure.
3 . The method of claim 1 , wherein step (c) creates a fluid seal between the anchoring mechanism and the internal cervical OS.
4 . The method of claim 1 , wherein the anchoring mechanism of the postpartum hemorrhage mitigation device comprises a placement marker that is configured to slide along an outside surface of the suction line, and wherein step (c) further comprises sliding the placement marker into a location on the suction line that provides for proper positioning of the suction line extension based on the size of the uterus.
5 . The method of claim 1 , wherein step (e) comprises applying a negative pressure of 100 mmHG to the suction line.
6 . The method of claim 1 , wherein step (d) comprises leaving the abdomen open to allow for visual monitoring of uterine collapse during at least a portion of the treatment period.
7 . The method of claim 1 , wherein step (g) is performed from one hour to twenty-four hours after completion of step (d).
8 . The method of claim 1 , wherein the anchoring mechanism of the postpartum hemorrhage mitigation device collapses enough during performance of step (g) to allow passage of the anchoring mechanism and the suction line extension through the cervical canal and vagina.
9 . The method of claim 1 , wherein the suction line extension further comprises one or more ports, and wherein step (e) further comprises drawing the fluid through the one or more ports into the suction line extension for evacuation from the uterus.
10 . The method of claim 1 , wherein the postpartum hemorrhage mitigation device further comprises a stylet that is configured to slide into the proximal portion of the suction line, and wherein step (b) further comprises inserting the stylet into the suction line to reinforce the suction line and to aid in guiding the distal portion of the suction line through the uterine cavity and into and through the cervix.
11 . The method of claim 1 , further comprising monitoring an amount of fluid withdrawn from the uterus through the suction line during the treatment period.
12 . A method of uterine hemostasis using a postpartum hemorrhage mitigation device that includes a suction line and an anchoring mechanism attached to the suction line, the suction line having a distal portion and a proximal portion, the distal portion including a tapered tip, and the proximal portion including a suction line extension configured to be disposed within a uterine cavity of a uterus after childbirth, wherein the anchoring mechanism is configured to slide along an outside surface of the suction line to selectively adjust a position of the anchoring mechanism with respect to the suction line extension, the method comprising:
(a) sliding the anchoring mechanism to a location on the suction line that will provide for proper positioning of the suction line extension based on the size of the uterus;
(b) inserting the tapered tip of the suction line through a cesarian incision into the uterine cavity;
(c) guiding the tapered tip of the suction line through the uterine cavity, into and through the cervix, and into and through the vagina;
(d) positioning the anchoring mechanism adjacent the internal cervical OS of the uterine cavity, thereby creating a fluid seal between the anchoring mechanism and the internal cervical OS;
(e) closing the cesarian incision to enclose the proximal portion of the suction line within the uterine cavity;
(f) removing the tapered tip from the suction line and connecting the distal portion of the suction line to a source of negative pressure, thereby introducing negative pressure to the uterine cavity via the suction line during a treatment period, which causes contraction of the uterus and evacuation of fluid from the uterus via the suction line extension;
(g) upon completion of the treatment period, detaching the suction line from the source of negative pressure; and
(h) extracting the suction line extension and the anchoring mechanism from the uterus by pulling the proximal portion of the suction line through the cervical canal and into the vagina.
13 . The method of claim 12 , wherein step (f) comprises applying a negative pressure of 100 mmHG to the suction line.
14 . The method of claim 12 , wherein step (e) comprises leaving the abdomen open to allow for visual monitoring of uterine collapse during at least a portion of the treatment period.
15 . The method of claim 12 , wherein step (h) is performed from one hour to twenty-four hours after completion of step (d).
16 . The method of claim 12 , wherein the anchoring mechanism of the postpartum hemorrhage mitigation device collapses enough during performance of step (h) to allow passage of the anchoring mechanism and the suction line extension through the cervical canal and vagina.
17 . The method of claim 12 , wherein the suction line extension further comprises one or more ports, and wherein step (f) further comprises drawing the fluid through the one or more ports into the suction line extension for evacuation from the uterus.
18 . The method of claim 12 , wherein the postpartum hemorrhage mitigation device further comprises a stylet that is configured to slide into the proximal portion of the suction line, and wherein step (c) further comprises inserting the stylet into the suction line to reinforce the suction line and to aid in guiding the distal portion of the suction line through the uterine cavity and into and the cervix.
19 . The method of claim 12 , further comprising monitoring an amount of fluid withdrawn from the uterus through the suction line during the treatment period.