Management of Postpartum Hemorrhage By Uterine Balloon Tamponade: Prospective Evaluation of Effectiveness
Saira Shaikh, Nasreen Fatima
Abstract
Objective
To determine the success rate of uterine balloon tamponade in patients with postpartum hemorrhage (PPH).
Study design
Cross sectional study.
Place & Duration of study
Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from June 2020 to December 2020.
Methods
Patients with postpartum hemorrhage were enrolled. Patients with uterine anomalies, diabetes mellitus, cardiac and renal diseases were excluded. Standard therapy of postpartum hemorrhage including Syntometrine® (oxytocin 5IU/ ergometrine 0.5 mg) intramuscular was given. If needed IV infusion of Syntocinon® (40 IU in 500ml 0.9% saline) and rectal misoprostol 600 microgram (3 pessaries) were used. When these measures failed then balloon catheters were inserted in the uterine cavity and filled with 60-90 ml tap water in delivery room. Failure of the balloon tamponade was defined as the persistence of the uterine bleeding with a need for additional procedure to arrest the hemorrhage. If bleeding stopped with intrauterine balloon tamponode, then procedure was considered as successful. The balloon was removed after 24-hours.
Results
A total of 139 patients with postpartum hemorrhage, between 17 to 45 years of age were enrolled. Majority (n=92 - 66.19%) of the patients were between 17 to 30 years of age. Mean gestational age was 36.40±2.27 weeks, mean parity 3.34±1.84, mean birth weight of the newborn was 2830.22±682.35 grams, mean preoperative and postoperative hemoglobin was 8.31±1.89 g/dl and 7.17±1.64 gm/dl respectively. Uterine balloon tamponade was found successful in controlling bleeding in 125 (89.93%) women.
Conclusion
The success rate of uterine balloon tamponade as an additional measure in patient with postpartum hemorrhage was highly successful.
Key words
Postpartum hemorrhage, Balloon tamponade, Obstetrical complication, Anemia, Misoprostol, Oxytocin.
