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.
References
[1] Aibar L, Aguilar MT, Puertas A, Valverde M. Bakri balloon for the management of postpartum hemorrhage. Acta Obstet Gynecol Scand. 2013;92:465–7.10.1111/j.1600-0412.2012.01497.xSearch in Google Scholar
[2] Akhter S, Bekum MR, Kabir Z, Rashid M, Laila TR, Fabeen F. Use of a condom to control massive postpartum hemorrhage. Med Gen Med. 2003;5:1–9.Search in Google Scholar
[3] Bakri YN. Balloon device for control of obstetrical bleeding. Euro J Obstet Gynecol Reprod Biol. 1999;86:S84.Search in Google Scholar
[4] Bakri YN, Amri A, Abdul Jabbar F. Tamponade-balloon for obstetrical bleeding. Int J Gynaecol Obstet. 2001;74: 139–42.10.1016/S0020-7292(01)00395-2Search in Google Scholar
[5] Condous GS, Arulkumaran S, Symonds I, Chapman R, Sinha A, Razvi K. The “tamponade test” in the management of massive postpartum hemorrhage. Obstet Gynecol. 2003;101:767–72.Search in Google Scholar
[6] Dabelea V, Schultze PM, McDuffie RS Jr. Intrauterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol. 2007;24:359–64.10.1055/s-2007-984402Search in Google Scholar
[7] Diemert A, Ortmeyer G, Hollwitz B, Lotz M, Somville T, Glosemeyer P, et al. The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage. Am J Obstet Gynecol. 2012;206:65.e1–4.10.1016/j.ajog.2011.07.041Search in Google Scholar
[8] Doumouchtsis SK, Papageorghiou AT, Vernier C, Arulkumaran S. Management of postpartum hemorrhage by uterine balloon tamponade: prospective evaluation of effectiveness. Acta Obstet Gynecol Scand. 2008;87:849–55.10.1080/00016340802179822Search in Google Scholar
[9] Ford JB, Roberts CL, Simpson JM, Vaughan J, Cameron CA. Increased postpartum hemorrhage rates in Australia. Int J Gynaecol Obstet. 2007;98:237–43.10.1016/j.ijgo.2007.03.011Search in Google Scholar
[10] Georgiou C. Balloon tamponade in the management of postpartum haemorrhage: a review. Br J Obstst Gynaecol. 2009;116:748–57.10.1111/j.1471-0528.2009.02113.xSearch in Google Scholar
[11] Goldrath MH. Uterine tamponade for the control of acute uterine bleeding. Am J Obstet Gynecol. 1983;147:869–72.10.1016/0002-9378(83)90237-5Search in Google Scholar
[12] Grönvall M, Tikkanen M, Tallberg E, Paavonen J, Stefanovic V. Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: a series of 50 cases from a tertiary teaching hospital. Acta Obstet Gynecol Scand. 2013;92: 433–8.10.1111/j.1600-0412.2012.01531.xSearch in Google Scholar PubMed
[13] Johanson R, Kumar M, Obhrai M, Young P. Management of massive postpartum haemorrhage: use of a hydrostatic balloon catheter to avoid laparotomy. Br J Obstst Gynaecol. 2001;108:420–2.Search in Google Scholar
[14] Katesmark M, Brown R, Raju KS. Successful use of a Sengstaken-Blakemore tube to control massive postpartum haemorrhage. Br J Obstet Gynaecol. 1994;101:259–60.10.1111/j.1471-0528.1994.tb13124.xSearch in Google Scholar PubMed
[15] Kaya B, Tüten A, Celik H, Mısırlıoğlu M, Unal O. Non-invasive management of acute recurrent puerperal uterine inversion with Bakri postpartum balloon. Arch Gynecol Obstet. 2014;289:695–6.10.1007/s00404-013-2993-7Search in Google Scholar PubMed
[16] Keriakos R, Mukhopadhyay A. The use of the Rusch balloon for management of severe postpartum haemorrhage. J Obstet Gynaecol. 2006;26:335–8.10.1080/01443610600595077Search in Google Scholar PubMed
[17] Knight M, Callaghan WM, Berg C. Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregn Childb. 2009;9:55.10.1186/1471-2393-9-55Search in Google Scholar PubMed PubMed Central
[18] Olsen R, Reisner DP, Benedetti TJ, Dunsmoor-Su RF. Bakri balloon effectiveness for postpartum hemorrhage: a “real world experience”. J Matern Fetal Neonatal Med. 2013;26:1720–3.10.3109/14767058.2013.796354Search in Google Scholar PubMed
[19] Panda B, Laifer S, Stiller R, Kleinman G. Primary atony of the lower uterine segment as a distinct cause of early postpartum haemorrhage: a case series and management recommendations. J Obstet Gynaecol. 2009;29:628–32.10.1080/01443610903114493Search in Google Scholar PubMed
[20] Porrecco RP, Stettler RW. Surgical remedies for postpartum hemorrhage. Clin Obstet Gynecol. 2010;53:182–95.10.1097/GRF.0b013e3181cc4139Search in Google Scholar PubMed
[21] Rathore AM, Gupta S, Manaktala U, Gupta S, Dubey C, Khan M. Uterine tamponade using condom catheter balloon in the management of non-traumatic postpartum hemorrhage. J Obstet Gynaecol Res. 2012;38:1162–7.10.1111/j.1447-0756.2011.01843.xSearch in Google Scholar PubMed
[22] Roberts CL, Ford JB, Algert CS, Bell JC, Simpson JM, Morris JM. Trends in adverse maternal outcome during childbirth. BMC Pregn Childb. 2009;9:7.10.1186/1471-2393-9-7Search in Google Scholar PubMed PubMed Central
[23] Seror J, Allouche C, Elhaik S. Use of Sengstaken-Blakemore tube in massive postpartum hemorrhage: a series of 17 cases. Acta Obstet Gynecol Scand. 2005;84:660–4.10.1111/j.0001-6349.2005.00713.xSearch in Google Scholar PubMed
[24] Vitthala S, Tsoumpou I, Anjum ZK, Aziz NA. Use of Bakri balloon in postpartum haemorrhage: a series of 15 cases. Aust NZ J Obstet Gynaecol. 2009;49:191–4.10.1111/j.1479-828X.2009.00968.xSearch in Google Scholar PubMed
[25] Vrachnis N, Salakos N, Iavazzo C, Grigoriadis C, Iliodromiti Z, Siristatidis C, et al. Bakri balloon tamponade for the management of postpartum hemorrhage. Int J Gynaecol Obstet. 2013;122:265–6.10.1016/j.ijgo.2013.03.028Search in Google Scholar PubMed
The authors stated that there are no conflicts of interest regarding the publication of this article.
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