Balloon tamponade for postpartum vaginal lacerations in a woman refusing blood transfusion

Yoong, Wai; Ray, Arpita; Phillip, S

doi:10.1016/j.ijgo.2009.03.052

Cited by 25 publications

(14 citation statements)

References 4 publications

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“…However, these balloon systems are not basically designed for vaginal use. In order to enable the balloon to remain in the vagina, it needs to be packed with sutures 5 6. A newly developed medical tool for conservative management of postpartum uterine bleeding, The Belfort-Dildy Obstetrical Tamponade System, trade named the ebb Complete Tamponade System (Glenveigh Medical, LLC, Chattanooga, Tennessee, USA) was approved by the US Food and Drug Administration (FDA) in 2010.…”

Section: Discussionmentioning

confidence: 99%

Complete tamponade system for management of severe postpartum vaginal haemorrhage due to uterine atony

et al. 2014

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A 30-year-old, 39 weeks pregnant, multiparous woman with single fetus, attended our obstetric clinic with complete cervical dilation in intractable mentum anterior presentation. The fetus was delivered by caesarean section with vertical uterine incision under general anaesthesia and lithotomy position. After surgery, examination of the vagina revealed multiple, serious tears with severe haemorrhage. Vaginal bleeding could not be controlled by sutures and concurrently uterine atony developed, which could not be controlled with medical treatment. Owing to intractable bleeding from uterus and vagina, a complete tamponade system was used. After the instillation of the uterine balloon with 500 mL and vaginal balloon with 300 mL liquid, the bleeding was controlled. The estimated blood loss was 3200 mL. The vaginal wound healed well during the postoperative 2 weeks. A complete tamponade system may be an effective treatment method for treatment of postpartum haemorrhage owing to vaginal lacerations and uterine atony.

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Section: Discussionmentioning

confidence: 99%

Complete tamponade system for management of severe postpartum vaginal haemorrhage due to uterine atony

et al. 2014

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“…Nonetheless, balloon systems used were not originally designed for vaginal use, were not self-retaining and additional sutures or further packing were always needed to fix the balloon in place [3,4]. …”

Section: Discussionmentioning

confidence: 99%

“…The use of another type of vaginal balloon tamponade has been described in the literature and, to the best of our knowledge, there are only 2 reported cases of the use of a balloon in severe postpartum hemorrhage secondary to vaginal lacerations [3,4]. The balloon cited in these case reports is the Bakri postpartum balloon (Cook Medical, USA).…”

Section: Introductionmentioning

confidence: 99%

“…In 2007, Tattersall and Braithwaite [3] reported a case of a PPVH that occurred in a 17-year-old woman at first pregnancy, after an apparently uncomplicated spontaneous vaginal delivery, and was treated with the insertion in the vagina of two separate Bakri balloons inflated with saline and further labial suture to retain the balloons in the vagina. Yoong et al [4], in 2009, reported a case of PPVH caused by multiple tears in an edematous and friable vaginal mucosa. The patient refused blood transfusion and after suturing, a Bakri balloon was placed in the vagina and filled with 100 ml of saline followed by gauze packing to prevent expulsion of the device.…”

Section: Introductionmentioning

confidence: 99%

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Use of Balloon Tamponade in Management of Severe Vaginal Postpartum Hemorrhage and Vaginal Hematoma: A Case Series

Ghirardini¹,

Alboni²,

Mabrouk³

2012

Gynecol Obstet Invest

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Severe vaginal lacerations and hematomas can be serious, life-threatening complications of vaginal delivery. The management is usually limited to suturing and vaginal packing with gauze. After a vaginal delivery vaginal tissues can be edematous, friable and very difficult to suture. Vaginal balloon tamponade can be a solution in difficult cases of intractable vaginal hemorrhage or occult vaginal bleeding causing vaginal hematoma. We describe the use of a new balloon device for vaginal hemostasis in 4 cases to treat bleeding and prevent hematoma formation from postpartum vaginal lacerations. According to our experience, the use of this balloon tamponade system in treating severe vaginal postpartum hemorrhage seems to be safe, effective and well tolerated by the patients.

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“…Expulsion of the balloon can be prevented by vaginal packing 20 , although this may conceal continuing bleeding around the balloon. If the balloon does not control haemorrhage or is repeatedly expelled it should be abandoned.…”

Section: Intrauterine Balloon Tamponadementioning

confidence: 99%

Caring for Pregnant Women for Whom Transfusion is Not an Option. A National Review to Assist in Patient Care

Kidson‐Gerber¹,

Kerridge²,

Farmer³

et al. 2017

Obstetric Anesthesia Digest

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Postpartum haemorrhage (PPH) is the leading cause of maternal mortality and morbidity globally. Obstetric bleeding can be catastrophic and management is challenging, involving a coordinated multidisciplinary approach, which may include blood products. In settings where blood transfusion is not an option, either because of patient refusal (most commonly in Jehovah Witnesses) or because of unavailability of blood, management becomes even more challenging. Observational studies have demonstrated an association between refusal of blood products in major obstetric haemorrhage and increased morbidity and mortality. This review draws upon evidence in the literature, physiological principles and expert opinion for strategies and guidance to optimise the outcomes of pregnant women in whom blood transfusion is either refused or impossible. The importance of a multidisciplinary antenatal and perinatal management plan, including optimisation of haemoglobin and iron stores pre-delivery, blood loss minimisation, early haemorrhage control and postpartum anaemia treatment, is discussed.

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Balloon tamponade for postpartum vaginal lacerations in a woman refusing blood transfusion

Cited by 25 publications

References 4 publications

Complete tamponade system for management of severe postpartum vaginal haemorrhage due to uterine atony

Complete tamponade system for management of severe postpartum vaginal haemorrhage due to uterine atony

Use of Balloon Tamponade in Management of Severe Vaginal Postpartum Hemorrhage and Vaginal Hematoma: A Case Series

Caring for Pregnant Women for Whom Transfusion is Not an Option. A National Review to Assist in Patient Care

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