scholarly journals A study of uterine balloon tamponade for the management postpartum haemorrhage using Bakri balloon

2021 ◽  
Vol 10 (9) ◽  
pp. 3347
Author(s):  
Shashikala B. Patil ◽  
Indumathi H. K. ◽  
Sarojini . ◽  
Savitha C.
Keyword(s):  
Vaginal Delivery ◽  
Surgical Management ◽  
Postpartum Haemorrhage ◽  
Research Centre ◽  
Common Cause ◽  
Medical College ◽  
Balloon Tamponade ◽  
Maternal Morbidity And Mortality ◽  
Uterine Balloon Tamponade ◽  
Bakri Balloon

Background: PPH is the most common cause of maternal morbidity and mortality around the world. Incidence of PPH is 2-4% following vaginal delivery and 6% following cesarean delivery in India. Uterine atony is the most common cause of PPH. Treatment of PPH involves medical treatment and surgical management. In between medical and surgical management of PPH comes uterine balloon tamponade which is simple, less invasive and can be managed with minimal training.Methods: A retrospective cohort study was done for 2 years at Vanivilas hospital, Bangalore medical college and research centre, Bangalore, Karnataka. Cases of atonic PPH managed using Bakri balloon were included in the study. The objective of the study was to study the effectiveness of uterine balloon tamponade using Bakri balloon in the management of atonic PPH and to study the maternal outcome.Results: In this study total of 50 cases were included. Women were in the age group of 18 to 33years. Regarding obstetric history, 22 (44%) were primigravida and 28 (56%) was multigravida. Among these 50 cases 8 (16%) women had undergone caesarean delivery and 42(84%) had vaginal delivery. All women received blood transfusion, 17 (34%) received blood and blood components (like PRBC, FFP AND platelets) and 33 (66%) cases received only PRBC transfusion. In these 50 cases, 32 (64%) required ICU admission for monitoring, remaining 18 (36%) were monitored in the labor-room. Bakri balloon was effective in 49 cases among 50. Success rate was 98%.Conclusions: Intrauterine balloon tamponade using Bakri balloon is effective for control of atonic PPH in majority of cases. 

scholarly journals A study of the efficacy and safety of the balloon tamponade in the management of atonic post-partum hemorrhage

2020 ◽  
Vol 9 (4) ◽  
pp. 1576
Author(s):  
Aruna Kumar ◽  
Khushboo Kachchhap ◽  
Shubha Shrivastava
Keyword(s):  
Post Partum ◽  
Post Partum Hemorrhage ◽  
Medical College ◽  
Balloon Tamponade ◽  
Maternal Morbidity And Mortality ◽  
Different Types ◽  
One Year ◽  
Gandhi Medical College ◽  
Condom Catheter ◽  
Bakri Balloon

Background: The most common cause of post-partum hemorrhage (PPH) is uterine atony. Treatment for atony follows a well-defined stepwise approach, including drugs and mechanical interventions followed by surgery as a last resort. Early use of intrauterine balloon tamponade is a way of limiting ongoing uterine blood loss while initiating other measures and can be readily implemented by providers with minimal training.Methods: This prospective interventional study was conducted in 112 consecutive patients attended department of obstetrics and gynecology, Gandhi Medical College and Associated Sultania Zanana Hospital, Bhopal, Madhya Pradesh, India, in one year of study period.Results: In this study most of the patients had gestational age >37 weeks [83 (74.1%)]. Most of the patients in the study had vaginal delivery [64 (57.1%)]. In 84 (75%) patients Bakri balloon was used followed by Burke balloon in 17 (15.2%) patients, condom catheter in 7 (6.2%) patients and CG balloon in 4 (3.6%) patients. Different types of balloons were used according to availability of balloon at the time of management. Most of the patients [71 (63.3%)] had trans-vaginal route of balloon placement and 41 (36.7%) patients underwent trans-abdominal balloon placement. Most of the patients 69 (61.65%), responded to tamponing within 20 minutes of balloon placement while 9 patients had negative tamponade and continued to bleed. Bakri balloon tamponade was most commonly used in 84 (75.0%) patients. CG balloon and condom catheter were used only in 4 (3.6%) and 7 (6.3%) patients respectively. Tamponading was effective and successful in 103 (92%) patients.Conclusions: PPH is still a leading but preventable cause of maternal morbidity and mortality. In the majority of cases, relatively simple methods are used to avert a disaster, although these are not always employed. Uterine tamponade using intrauterine balloons appears to be an effective tool in the management of PPH.

A Postpartum Haemorrhage Package With Condom Uterine Balloon Tamponade

2017 ◽  
Vol 37 (2) ◽  
pp. 84-85
Author(s):  
T.F. Burke ◽  
R. Ahn ◽  
B.D. Nelson ◽  
R. Hines ◽  
J. Kamara ◽  
...  
Keyword(s):  
Postpartum Haemorrhage ◽  
Balloon Tamponade ◽  
Uterine Balloon Tamponade

Management of postpartum haemorrhage with uterine balloon tamponade: The way forward

2015 ◽  
Vol 55 (4) ◽  
pp. 315-317 ◽  
Author(s):  
Jeevan P. Marasinghe ◽  
Jacobus Du Plessis ◽  
Dinesh Epitawela ◽  
Mark P. Umstad
Keyword(s):  
Postpartum Haemorrhage ◽  
Balloon Tamponade ◽  
Uterine Balloon Tamponade ◽  
The Way

scholarly journals Conservative surgical management for immediate postpartum hemorrhage

2019 ◽  
Vol 13 (3) ◽  
pp. 107-111
Author(s):  
Pimpitcha Puangsricharoen ◽  
Tarinee Manchana
Keyword(s):  
Surgical Management ◽  
Uterine Artery ◽  
Subsequent Pregnancy ◽  
Success Rates ◽  
Artery Ligation ◽  
Balloon Tamponade ◽  
Uterine Artery Ligation ◽  
Uterine Compression Suture ◽  
Compression Suture ◽  
Bakri Balloon

Abstract Background Conservative surgical management for postpartum hemorrhage (PPH), such as balloon tamponade, uterine compression suture, and uterine artery ligation, has the benefit of preserving reproductive function. Objectives To assess the efficacy and subsequent pregnancy outcome of conservative surgical management for patients with immediate PPH. Methods Medical records of patients who had PPH between January 2011 and December 2016 were reviewed. Conservative surgical management included B-Lynch uterine compression suture, Bakri balloon tamponade, and uterine artery ligation. The treatments were considered successful if patients did not require subsequent hysterectomy. Perioperative complications and subsequent pregnancy outcomes were recorded. Results Of 30,271 deliveries, 669 patients experienced PPH or 2.2% of total deliveries. Sixty-one patients (9.1%) did not respond to medical treatment with various uterotonic agents. Hysterectomy was selected initially in 30 patients. Conservative surgical management was performed in 31 patients: 15 Bakri balloon tamponade, 13 uterine compression suture, and 3 uterine artery ligation. There were 3 patients who failed Bakri balloon tamponade and proceeded to perform uterine compression suture with successful outcome. The success rates for conservative surgical treatment were 66.7%, 75%, and 66.7%, respectively. All patients who had successful conservative surgical management resumed normal menstruation. Three out of 11 patients (27.3%) who desired subsequent pregnancy were able to conceive and carry out a viable pregnancy. Conclusion Conservative surgical management has acceptable success rates for controlling intractable immediate PPH. Implementation of such procedures should be done to preserve fertility and decrease maternal morbidity and mortality.

scholarly journals Cost of managing atonic postpartum haemorrhage with uterine balloon tamponade devices in public health settings of Maharashtra, India: an economic microcosting study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042389
Author(s):  
Siddesh Sitaram Shetty ◽  
Kusum Venkobrao Moray ◽  
Himanshu Chaurasia ◽  
Beena Nitin Joshi
Keyword(s):  
Public Health ◽  
Health System ◽  
Annual Cost ◽  
Postpartum Haemorrhage ◽  
Public Health System ◽  
Health Facilities ◽  
Health Management Information System ◽  
Public Health Facilities ◽  
Balloon Tamponade ◽  
Uterine Balloon Tamponade

ObjectivePostpartum haemorrhage (PPH) is the worldwide leading cause of preventable maternal mortality. India offers free treatment for pregnancy and related complications in its public health facilities. Management with uterine balloon tamponade (UBT) is recommended for refractory atonic PPH cases. As part of health technology assessment to determine the most cost-effective UBT device, this study estimated costs of atonic PPH management with condom-UBT, Every Second Matters (ESM) UBT and Bakri balloon UBT in public health system of Maharashtra, India.DesignHealth system cost was estimated using primary economic microcosting, data from Health Management Information System and published literature for event probabilities.SettingsFour public health facilities from the state of Maharashtra, India representing primary, secondary and tertiary level care were chosen for primary costing.Outcome measuresUnit, package and annual cost of atonic PPH management with three UBT devices were measured. This included cost of medical treatment, UBT intervention and PPH related surgeries undertaken in public health system of Maharashtra for year 2017–2018.ResultsMedical management of atonic PPH cost the health system US$37 (95% CI 29 to 45) per case, increasing to US$44 (95% CI 36 to 53) with condom-UBT and surgical interventions for uncontrolled cases. Similar cost was estimated for ESM-UBT. Bakri-UBT reported a higher cost of US$59 (95% CI 46 to 73) per case. Overall annual cost of managing 27 915 atonic PPH cases with condom-UBT intervention in Maharashtra was US$1 226 610 (95% CI 870 250 to 1 581 596).ConclusionsAtonic PPH management in public health facilities of Maharashtra with condom-UBT, ESM-UBT or Bakri-UBT accounts to 3.8%, 3.8% or 5.2% of the state’s annual spending on reproductive and child health services. These findings can guide policy-makers to include PPH complication management in publicly financed health schemes. Economic evaluation studies can use this evidence to determine cost effectiveness of UBT in Indian settings.

scholarly journals Factors Associated with Failure of Bakri Balloon Tamponade for the Management of Postpartum Haemorrhage. Case Series Study and Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 295
Author(s):  
Francisco Ruiz Labarta ◽  
María Pintado Recarte ◽  
Laura Joigneau Prieto ◽  
Coral Bravo Arribas ◽  
Julia Bujan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Caesarean Delivery ◽  
Postpartum Haemorrhage ◽  
Case Series ◽  
Cochrane Library ◽  
Balloon Tamponade ◽  
Estimated Blood Loss ◽  
Case Series Study ◽  
Series Study ◽  
Bakri Balloon

Background: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Bakri balloon tamponade (BBT) is recommended when PPH does not respond to medical treatment. Nowadays few published studies have performed a multivariate analysis to determine the variables independently associated with BBT failure. Methods: Our study purpose was to determine the variables independently associated with BBT failure: first, in a large single-centre cohort study between 2010 and 2020, and second, in a systematic literature review using Medline and the Cochrane Library. Maternal and perinatal variables, PPH characteristics, technique-related variables and complications were recorded in the case series study, comparing between successful and failed BBT patients. Study characteristic and variables significantly associated with BBT failure were recorded in the systematic review. All studies used a logistic regression test. Results: The case series included 123 patients. The profile of these patients were primiparous, with vaginal delivery and a full-term new-born. BBT was successful in 81.3% of cases. Five studies were included in the systematic review, providing data from 551 patients. BBT was successful in 79.5% of cases. Conclusions: Maternal age, caesarean delivery, ≥7 red blood cells units (RBCU) transfused and curettage before BBT insertion, history of caesarean section, pre-pregnancy obesity, anteriorly placed placenta, placenta accreta, caesarean delivery, estimated blood loss before insertion of BBT, long operation duration, and coagulopathy were independent factors for BBT failure.

scholarly journals Uterine balloon tamponade as an adjunct to misoprostol for the treatment of uncontrolled postpartum haemorrhage: a randomised controlled trial in Benin and Mali

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016590 ◽  
Author(s):  
Alexandre Dumont ◽  
Cécile Bodin ◽  
Benjamin Hounkpatin ◽  
Thomas Popowski ◽  
Mamadou Traoré ◽  
...  
Keyword(s):  
Relative Risk ◽  
Randomised Controlled Trial ◽  
Postpartum Haemorrhage ◽  
Controlled Trial ◽  
Case Fatality ◽  
Control Group ◽  
Total Blood ◽  
Balloon Tamponade ◽  
Uterine Balloon Tamponade ◽  
Randomised Controlled

ObjectiveTo assess the effectiveness of low-cost uterine tamponade as an adjunct to misoprostol for the treatment of uncontrolled postpartum haemorrhage (PPH) in low-resource settings.DesignRandomised controlled trial.SettingSeven healthcare facilities in Cotonou, Benin and Bamako, Mali.PopulationWomen delivering vaginally who had clinically diagnosed PPH that was suspected to be due to uterine atony, who were unresponsive to oxytocin and who needed additional uterotonics.MethodsWomen were randomly assigned to receive uterine balloon tamponade with a condom-catheter device or no tamponade; both groups were also given intrarectal or sublingual misoprostol.Main outcome measureProportion of women with invasive surgery or who died before hospital discharge.ResultsThe proportion of primary composite outcome did not differ significantly between the tamponade arm (16%; 9/57) and the standard second line treatment arm (7%; 4/59): relative risk 2.33 (95% CI 0.76 to 7.14, p=0.238). A significantly increased proportion of women with tamponade and misoprostol versus misoprostol alone had total blood loss more than 1000 mL: relative risk 1.52 (95% CI 1.15 to 2.00, p=0.01). Case fatality rate was higher in the tamponade group (10%; 6/57) than in the control group (2%; 1/59) (p=0.059).Trial registration numberISRCT Registry Number 01202389; Post-results.

Sign in / Sign up

Export Citation Format

Share Document