Here we provide the resources from our programs for physicians, residents, and students to review and pass on.
It is our hope that trainees will use these resources to refresh their knowledge and to teach others. To this end, we have included guides to making our simulation models; trainees can continue practicing on these models or use them as a teaching tool. A Downloadable Manual containing most of the resources offered on this website can also be accessed here for those who have inconsistent internet or prefer physical copies.
GO MOMS Program for Obstetrical Emergencies
Postpartum hemorrhage is the leading cause of maternal mortality globally. In many developing countries, physicians respond to PPH with a hysterectomy. GO MOMS' goal is to demonstrate fertility-sparing methods that control postpartum hemorrhage. Our trainees practice simulations of intrauterine balloon tamponades and B-Lynch sutures before a practical simulation in which they have to respond to a hemorrhaging patient.
Postpartum hemorrhage Presentation and handout
Intrauterine Balloon Tamponade
The Bakri balloon system is commonly used in the United States to perform uterine balloon tamponade as it effectively stops hemorrhage in 77.5 to 88.8 percent of cases. The cost of a Bakri balloon is 250 USD, so it is unavailable in developing countries. A cheaper alternative to the Bakri balloon is the condom balloon, proposed by Dr. Sayeba Akhter and colleagues in 2003. It is made from a condom, a Foley catheter, string or spare suture, and sterile water or saline. The total cost of the device is less than 5 USD. In GO MOMS simulations, residents practice making and inserting condom tamponade balloons in neoprene vaginal models.
The B-Lynch suture is a form of compression suture used to mechanically compress an atonic uterus in the face of severe postpartum hemorrhage. To simulate a B-Lynch compression suture, we use models made of neoprene sewn together to make a pouch. Residents develop tactical muscle memory in performing a B-Lynch suture and also discuss the indications for B-Lynch and the correct suture material.
GO GYNS Program for Gynecologic Care
Currently GO GYNS training programs address uterine prolapse by training physicians to fit and place pessaries, and also teach physicians how to perform vaginal hysterectomies.
Vaginal pessaries are a great alternative to surgical management if a patient is not a good candidate for surgery, does not desire surgery, or does not have access to a gynecologic surgeon. Pessaries can be used to treat a variety of pelvic floor disorders such as uterine prolapse, urinary incontinence, and urinary retention. Using a pessary prior to surgery can allow tissue inflammation and ulceration to heal properly to ensure a better surgical outcome. Our foam model can be easily made and used to practice fitting the most common pessary types (donut and ring).
Many of the physicians and students we encounter in our GO GYNS program have experience performing abdominal hysterectomies, but few have practiced vaginal hysterectomies. Vaginal hysterectomies are associated with better results and fewer complications than laparoscopic and abdominal hysterectomies. Whenever possible, a vaginal hysterectomy is the safest and most economic method to remove the uterus. .
A downloadable manual featuring some of these resources can be found here: