To show the efficacy of double-balloon cervical ripening catheter in the management of postpartum hemorrhage originating from the lower segment of the uterus or the upper parts of the vagina.MethodsPatients with intractable bleeding from the lower segment of the uterus and the upper parts of the vagina after Cesarean or vaginal deliveries were treated by double-balloon cervical ripening catheter.ResultsDouble-balloon catheter was used in seven patients, and it was properly placed in all of them. No other intervention was needed to control bleeding. Two patients were delivered vaginally, and five patients were delivered by Cesarean section. Length of hospitalization was longer in the vaginal delivery patients (average hospitalization was 12 days in the vaginal delivery patients and 5 days in the Cesarean section patients). The need for blood and blood products transfusion (average of blood and blood products transfusion was 30 U in the vaginal delivery patients and 6 U in the Cesarean patients) was also higher in the vaginal delivery patients.ConclusionAlthough double-balloon cervical ripening catheter is designed for the induction of labor, it can successfully control intractable bleedings from the lower segment of the uterus and the upper parts of the vagina. This procedure can save patients from undergoing more morbid procedures.
BackgroundWe aimed to investigate the treatment efficacy of ampicillin prophylaxis accompanied by Lactobacillus casei rhamnosus over the latency period following preterm premature rupture of membranes (PPROM).MethodsRecords of 40 patients who presented with PPROM between 230/7–316/7 weeks were analyzed retrospectively. Patients were divided into two groups: group 1 (n=20), treated with ampicillin; and group 2 (n=20), treated with ampicillin plus L. casei rhamnosus. Clinical and laboratory parameters were compared. Delta (Δ) values of each laboratory parameter were calculated by subtracting the value at delivery from the values at admission to the clinic.ResultsGestational weeks at delivery (28.1±0.3 weeks versus 31.5±0.4 weeks), latency periods (12.3±1.5 days versus 41.4±4.4 days), 5-minute APGAR scores (6.8±0.1 versus 7.8±0.1), and birth weights (1,320±98 g versus 1,947±128 g) were significantly higher in group 2. White blood cell (WBC) (12,820±353/mm3 versus 11,107±298/mm3), and neutrophil counts (10.7±0.5×103/L versus 8.2±0.5×103/L) were significantly lower in group 2 at delivery. The ΔWBC (2,295±74/mm3 versus −798±−406/mm3), ΔC-reactive protein (5±0.04 mg/L versus 1.6±0.2 mg/L), and Δneutrophil (3±0.2×103/L versus 0.2±−0.1×103/L) were significantly lower in group 2.ConclusionIt seems that addition of L. casei rhamnosus to ampicillin prolongs the latency period in patients with PPROM remote from term.
There are two methods that are effective in preventing bleeding in CPP. However, the Bakri balloon tamponade may be a better alternative due to a shorter operation time and less blood loss.
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