Abstract | OBJECTIVE: The purpose of this study was to investigate changes in invasive procedure rates after the addition of intrauterine balloon tamponade as an initial second-line therapy to our protocol for the management of severe postpartum hemorrhage. STUDY DESIGN: We compared the outcomes of all patients with postpartum hemorrhage that was unresponsive to prostaglandin during 2 equal periods, before (first period) and after (second period) the introduction of a balloon tamponade protocol. RESULTS: During the second period, 43 women had uterine tamponade with a Bakri balloon as their initial second-line therapy (after vaginal delivery, 31; after caesarean delivery, 12). The global success rate was 86% (37/43 women). Among patients who delivered vaginally, the rates of arterial embolization (8.2% vs 2.3% in the first and second period; P = .006; odds ratio, 0.26; 95% confidence interval, 0.09-0.72) and conservative surgical procedures (5.1% vs 1.4%, in the first and second period; P = .029; odds ratio, 0.26; 95% confidence interval, 0.07-0.95) were significantly lower after the uterine tamponade test was added to our protocol. CONCLUSION: Intrauterine balloon tamponade is an attractive adjunctive strategy for the achievement of hemostasis in intractable hemorrhages and prevention of the need for invasive procedures.
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Authors | Enora Laas, Charles Bui, Thomas Popowski, Olivier Matondo Mbaku, Patrick Rozenberg |
Journal | American journal of obstetrics and gynecology
(Am J Obstet Gynecol)
Vol. 207
Issue 4
Pg. 281.e1-7
(Oct 2012)
ISSN: 1097-6868 [Electronic] United States |
PMID | 23021688
(Publication Type: Journal Article)
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Copyright | Copyright © 2012 Mosby, Inc. All rights reserved. |
Topics |
- Adult
- Cesarean Section
- Delivery, Obstetric
- Female
- Hemostatic Techniques
(trends)
- Humans
- Postpartum Hemorrhage
(surgery, therapy)
- Pregnancy
- Uterine Balloon Tamponade
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