{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:53:48Z","timestamp":1789523628773,"version":"build-2803163510"},"reference-count":9,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Postpartum hemorrhage is a common obstetrical emergency. Because the majority of cases respond to conservative medical therapies, trainees have limited clinical experience with hemostatic sutures or placement of a Bakri intrauterine balloon for refractory postpartum hemorrhage. Simulations provide an invaluable adjunct to resident education to learn and practice these hemostatic techniques. We aimed to create a low-cost, reproducible simulation model to prepare residents for uterine atony interventions such as B-Lynch, Bakri balloon placement, and uterine artery ligation.<\/jats:p><jats:p>\n            Study Design\u2003Using low-cost supplies, a reusable, life-sized recent postpartum uterus was constructed from pieces of sheepskin and sewn together with various expired suture. The sheepskin material allowed for repeated, secure placement of B-Lynch and O'Leary sutures and Bakri balloons, as well as offering the required compressibility to simulate a boggy uterus. Finally, sections of a red robin catheter were incorporated along the lateral lower borders of the model to simulate blood vessels for practicing uterine artery ligations.<\/jats:p><jats:p>\n            Results\u2003The model was used about 50 times over the span of 3 years to practice uterine hemostatic suturing. Residents found this model lifelike, accurate in size, and multifunctional for practicing these various techniques. The sheepskin material proved to be very resistant to repeated suturing, and also provided strong suture pull through strength. The durability of the sheepskin material demonstrates that this model can be used for repeated simulations or individual practice.<\/jats:p><jats:p>\n            Conclusion\u2003The sheepskin uterus model provides trainees a realistic, low-cost, reproducible, simulation of a hypotonic uterus and allows for multiple modalities for managing postpartum hemorrhage.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1776415","type":"journal-article","created":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T00:01:36Z","timestamp":1699056096000},"page":"e3003-e3007","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Low-Cost, Durable Sheepskin Uterine Model for Obstetric Hemorrhage Emergency Simulation"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1197-9288","authenticated-orcid":false,"given":"Alicia","family":"Lunardhi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, Torrance, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hindi Elaine","family":"Stohl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance","family":"Betson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"591.e1","DOI":"10.1016\/j.ajog.2013.08.010","article-title":"A tool for teaching the B-Lynch brace suture method: an inexpensive new simulator allows obstetricians to polish an essential technique","volume":"209","author":"N Pereira","year":"2013","journal-title":"Am J Obstet Gynecol"},{"issue":"06","key":"ref4","first-page":"e2725","article-title":"Towel uterus model for uterine compression sutures technical skills training: a review of literature and development of a performance rubric","volume":"10","author":"M Garofalo","year":"2018","journal-title":"Cureus"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"367","DOI":"10.4300\/JGME-D-11-00186.1","article-title":"A novel approach to teaching placement of a B-lynch suture: description of technique and validation of teaching model","volume":"4","author":"P F Vetere","year":"2012","journal-title":"J Grad Med Educ"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1136\/bmjstel-2019-000551","article-title":"Emergency surgical obstetrics simulation training: an ex vivo low-cost model using bovine uterus and porcine bladder for haemostatic uterine brace suture techniques","volume":"7","author":"A Sinclair","year":"2020","journal-title":"BMJ Simul Technol Enhanc Learn"},{"issue":"03","key":"ref7","first-page":"189","article-title":"Uterine artery ligation in the control of postcesarean hemorrhage","volume":"40","author":"J A O'Leary","year":"1995","journal-title":"J Reprod Med"},{"issue":"07","key":"ref8","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/0002-9378(66)90026-3","article-title":"Uterine artery ligation in the control of intractable postpartum hemorrhage","volume":"94","author":"J L O'Leary","year":"1966","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref9","first-page":"106","article-title":"Effect of ligation of descending branch of uterine artery in the treatment of post-partum hemorrhage caused by uterine atony and evaluation of reducing the risk of puerperal disease","volume":"78","author":"Y An","year":"2023","journal-title":"Minerva Surg"},{"issue":"06","key":"ref10","first-page":"e8525","article-title":"Uterine sandwich method: a case of posterior placenta previa in an in vitro fertilization pregnancy complicated by velamentous cord insertion","volume":"12","author":"J Farshchian","year":"2020","journal-title":"Cureus"},{"issue":"11","key":"ref11","first-page":"e11492","article-title":"Uterine sandwich suture: the concept of \u201crole sharing\u201d is important","volume":"12","author":"S Matsubara","year":"2020","journal-title":"Cureus"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1776415.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:45:50Z","timestamp":1730814350000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1776415"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,3]]},"references-count":9,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1776415","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,3]]}}}