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J Perinat Med. 2014 Nov;42(6):745-53. doi: 10.1515/jpm-2013-0336.

Balloon tamponade for the management of postpartum uterine hemorrhage.

Abstract

OBJECTIVE:

To evaluate the use of the Bakri balloon in postpartum hemorrhage (PPH) resistant to medical treatment.

METHODS:

The Bakri balloon was applied to 45 women with PPH after failure of initial management. Bilateral internal iliac artery ligation (BIIAL) and hysterectomy were performed if necessary.

RESULTS:

The Bakri balloon was applied in 45 women; an additional BIIAL was required in nine women. The mean inflation volume of the Bakri balloon was 571±264 mL (range: 240-1300 mL). Hemostasis was achieved in 34 (75.5%) women with the Bakri balloon alone, and in six women with an additional BIIAL. The Bakri balloon was effective with additional procedures overall in 40 of 45 (88.8%) women. In 34 women with uterine atony, the Bakri balloon was successful alone in 27 (79.4%) and with an additional BIIAL in 30 (88.2%) women. An inflation volume of >500 mL was necessary in 18 women with uterine atony.

CONCLUSION:

The Bakri balloon may be performed as a first line of treatment for PPH resistant to uterotonic agents, and can be used not only in tertiary centers but also in limited-resource centers. The inflation volume of the Bakri balloon should be adjusted according to the type of PPH; a volume exceeding 500 mL may be necessary in uterine atony.

PMID:
24663227
DOI:
10.1515/jpm-2013-0336
[Indexed for MEDLINE]

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