# Failure of Sequential JADA® Devices in Major Postpartum Hemorrhage Requiring Emergent Supracervical Hysterectomy: A Case Report

## TL;DR

A case report shows that JADA® devices failed to control severe postpartum bleeding, requiring emergency surgery.

## Contribution

This case highlights real-world failure of JADA® devices in major postpartum hemorrhage and underscores the need for timely surgical escalation.

## Key findings

- Sequential JADA® devices failed to control bleeding in a patient with uterine atony.
- The patient required supracervical hysterectomy after device failure and uterotonic therapy.
- The case emphasizes the importance of recognizing device limitations and escalating care promptly.

## Abstract

Major postpartum hemorrhage (PPH) continues to be a significant contributor to maternal health complications, and rapid control of bleeding is essential to prevent hemodynamic instability and the need for surgical intervention. The JADA® uterine vacuum system has been increasingly adopted as a primary tool to manage PPH caused by uterine atony. Although reported success rates are high, particularly when used early, device failure can still occur and requires timely escalation of care. We present the case of a 30-year-old woman, gravida 3 para 2, who developed major PPH following a spontaneous vaginal delivery at term. Her bleeding was attributed to uterine atony and persisted despite the administration of multiple uterotonic agents, including Pitocin, methylergonovine, Hemabate, rectal misoprostol, and tranexamic acid. A JADA® device was placed but did not achieve adequate hemorrhage control. A second JADA® device was subsequently inserted, yet bleeding continued. The patient required transfusion of packed red blood cells and was taken emergently to the operating room for a supracervical hysterectomy, after which her condition stabilized. This case demonstrates sequential JADA® device failure in the setting of major PPH and emphasizes the need for clinicians to promptly recognize insufficient response, understand the limitations of uterine vacuum systems, and be prepared to escalate to surgical management when bleeding persists. As the JADA® device becomes further integrated into PPH algorithms, documenting real-world experiences with device failure is essential for refining clinical expectations, improving patient care, and reducing mortality.