Treatment for post partum hemorrhage

Abstract

The invention is directed to instruments and procedures using such instruments for temporarily reducing or terminating blood flow through a female patient's uterine artery to treat post partum hemorrhage (PPH). The uterine artery is occluded by a clamping device which includes a pair of pivotally connected clamping members, with each of the clamping members having a handle and a clamping element at the distal end of the handle. The clamping elements are inclined with respect to the longitudinal axes of the handles at an included obtuse angle between about 120° and about 170°, preferably between about 130° and 160°. An artery locating sensor is provided on the distal end of at least one of the clamping elements. Preferably, the artery locating sensor is a Doppler ultrasound blood flow sensor. After birth, the clamping device is inserted into the female patient's post partum vaginal canal and advanced therein until one of the clamping elements Is in the patient's uterine cervix and the other clamping element is on the exterior of the uterine cervix. The clamping element on the exterior of the patient's uterine cervix is pressed against the patient's vaginal fornix and the clamping device closed so as to occlude the uterine artery disposed within tissue grasped by the clamping device. The clamping device is locked in the closed configuration and maintained in the condition until the patient's uterus is sufficiently clotted up to ensure termination of the hemorrhaging, typically about 5 minutes to about 7 hours.

Description

[0001] This application is a continuation of application Ser. No. 10 / 355,809, filed Jan. 30, 2003 from which priority is claimed and which is incorporated herein in its entirety.FIELD OF THE INVENTION [0002] The invention relates generally to the field of devices and treatments of diseases and conditions by the regulation of blood flow in blood vessels. In particular, the invention is directed to the treatment of post partum hemorrhage by reducing or terminating blood flow to a female patient's uterus after giving birth. BACKGROUND OF THE INVENTION [0003] Some women bleed to death following childbirth. If the blood supply to the uterus can be controlled soon after birth, such deaths can be prevented. The blood supply to the uterus is predominantly from the right and left uterine arteries. In most women, the origin of each uterine artery is from the anterior division of the internal iliac artery. The uterine arteries reach the uterus traveling in the retroperitoneum and broad ligamen...

AI Technical Summary

Benefits of technology

The device enables rapid and effective occlusion of uterine arteries, reducing or eliminating postpartum hemorrhage, allowing for sufficient clotting and minimizing the risk of further bleeding without the need for surgical intervention.

Problems solved by technology

However, with the expansion of the uterus into the abdomen as the pregnancy term lengthens, the uterine arteries can no longer be palpated during a bimanual pelvic examination because they are too far away from the vaginal introitus to be reached by an examiner's fingers (typically about 19 cm).

Although uterine contractions following birth are generally sufficient to slow the velocity of blood flowing through the uterus to initiate blood clot formation throughout myometrium, in some women uterine contractions are inadequate.

However, these pharmaceutical agents produce side effects on the vasculature not just in the uterus but throughout the body.

If the uterine packing fails, more complex surgery is performed.

Though noninvasive, this method has no means for positively identifying whether or nor any artery has been compressed by the two sets of forceps.

As a result, the method has not been adopted.

However, because vascular surgery is not generally taught in obstetric residencies, the technique is not widely practiced.

Though effective, these techniques are not universally available and there is considerable time delay between the onset of postpartum hemorrhage and the transfer to an angiographic suite—commonly in different parts of the same hospital.

Furthermore, since angiography is performed by radiologists and babies are delivered by obstetricians, communication gaps arise between the two specialties.

Ligation of the uterine arteries is effective at stopping postpartum hemorrhage, but the procedure is invasive and time consuming.

However, because the angiographic methods are performed by different specialists at different locations, there is frequently insufficient time to perform them for effective treatment of PPH.

Moreover, the procedure leaves the mother infertile.

Accordingly, there is need for uncomplicated instruments that can be rapidly deployed to partially or completely terminate blood flow in blood vessels such as the uterine arteries, particularly in the case of PPH.

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