Abstract
Postpartum hemorrhage (PPH) continues to be a major threat to maternal health worldwide. Current management strategies include uterotonic agents, intrauterine tamponade devices, and surgical interventions. These methods have variable efficacy, carry potential complications, and contribute to significant healthcare costs. The JADA device is an emerging and promising tool for managing PPH. We report the case of a 19-year-old G2P1011 at 39w3d who experienced uterine atony following a spontaneous vaginal delivery. Despite administration of Pitocin and tranexamic acid, the patient continued to have brisk vaginal bleeding after placental delivery. She was subsequently transferred to the OR for an exam under anesthesia due to her intolerance of pelvic examinations. Uterine atony was confirmed, and a second-degree perineal laceration with minimal bleeding was noted. The decision was made to place a JADA device when the bleeding did not resolve with uterotonics and bimanual massage. The second-degree perineal laceration was repaired in standard fashion. The JADA device was successfully removed after 30 minutes, rather than the manufacturer-recommended one-hour duration. Total quantified blood loss was 1300 mL. The patient was stable for discharge on postoperative day 2 and had an uncomplicated postoperative and postpartum course despite early removal of the JADA device. This case highlights the efficacy and safety of early JADA removal in the management of PPH. Recent data suggest that the JADA offers distinct advantages over traditional tamponade devices such as the Bakri balloon. The device's versatility may be particularly beneficial in settings where prolonged placement is not feasible. Beyond obstetrics, the JADA device has shown potential in gynecologic procedures, such as after myomectomies. Overall, the JADA device offers a safe, effective, and versatile tool for PPH management. This case contributes to the growing evidence supporting its role in individualized care and underscores the need for further studies exploring early removal protocols.