Managing Spontaneous Abortion Hemorrhage: An Adult Simulation Case for Emergency Medicine Residents.

StudyJournal of education & teaching in emergency medicine· Jul 2026

Managing Spontaneous Abortion Hemorrhage: An Adult Simulation Case for Emergency Medicine Residents.

Brendan Freeman, Ritika Gudhe, Rodrigo Kong … Anand Swaminathan

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Family Planning & ContraceptionStudy

Simulation training sharply improved residents' knowledge of post-abortion hemorrhage management

Managing Spontaneous Abortion Hemorrhage: An Adult Simulation Case for Emergency Medicine Residents.

Brendan Freeman … Anand Swaminathan

Journal of education & teaching in emergency medicine · Jul 2026

Background

Postpartum hemorrhage (postpartum hemorrhage) is defined as cumulative blood loss ≥1000 mL or any postpartum bleeding with signs of hypovolemia within 24 hours of delivery.

Purpose

By the end of this simulation, learners should be able to: 1) recognize signs of post-abortion hemorrhage, 2) manage hemorrhage using appropriate physical maneuvers, uterotonic medications, and specialist consultation, 3) demonstrate proper placement of a Bakri balloon.

Methods

This single-center, high-fidelity simulation was conducted at a tertiary care academic center.

Results

knowledge test scores nearly doubled after simulation training

More results

The simulation included 29 emergency medicine residents, four MS3 students, four MS4 students, and three junior EM PA fellows.

The simulation lasts approximately 20 minutes.

There were statistically significant improvements across all measures.

More results

On a 5-point Likert scale, comfort in placing a Bakri balloon increased from 2.35 to 3.97 (U = 82, z = 5.34, P < 0.01); comfort in managing postpartum/abortion hemorrhage rose from 3.11 to 3.90 (U = 197, z = 3.59, P < 0.01), and recognition of hemorrhage signs increased from 3.96 to 4.39 (U = 278, z = 2.36, P = 0.02).

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Conclusion

TOPICS: Postpartum hemorrhage, post-abortion hemorrhage, Bakri balloon, uterine tamponade, simulation training.

Managing Spontaneous Abortion Hemorrhage: An Adult Simulation Case for Emergency Medicine Residents.

Managing Spontaneous Abortion Hemorrhage: An Adult Simulation Case for Emergency Medicine Residents.

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