Double-balloon tamponade in the management of postpartum hemorrhage: a case series

Kavak, Salih Burçin; Kavak, Ebru Çelik; Demirel, İsmail; Ilhan, Rasit

doi:10.2147/tcrm.s62574

Cited by 13 publications

(9 citation statements)

References 8 publications

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“…In recent papers, surgical treatment of LUSA was described by means of different methods like: curettage, embolisation, vaginal packing, bilateral cervix apex clamping, transvaginal cervicouterine artery ligation, double balloon tamponade, obstruction of vascularisation by means of uterine traction towards vagina, "holding the cervix" technique, " shing for the balloon shaft" and perpendicular compressive cervical stitches and nally hysterectomy [6,9,[10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Panda et al [6] in 2009. published very appreciable paper about clinical entity known as primary LUSA that should be clearly distinguished from corporeal uterine atony.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Early Postpartum Hemorrhage Caused by Lower Uterine Segment Atony

Habek¹,

Márton

Prka

et al. 2021

Preprint

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Purpose: Lower uterine segment atony is recently being recognized as one of the major reasons for early postpartum hemorrhage.Methods: We present our experience in surgical treatment of lower uterine segment atony patients that were delivered in our tertiary perinatal center during the 10 years period (2010-2019).Results: This particular study enrolled total number of 29 543 deliveries with 215 cases of early PPH (0,72%). LUSA was diagnosed in 44 cases or in 29,93% in all uterine atony cases. Exploration of the lower uterine segment accompanied by evacuation of the coagula was conducted in 5 cases (11,36%), haemostatic ligation procedures according to authors: Losickaja in 2 cases, Hebisch-Huch in 9 cases, Habek in 5 cases, Hebisch-Huch+Losickaja in 9 cases. Evacuation procedures were combined with ligation techniques in 7 cases, evacuation methods with ligation techniques and balloon tamponade in 2 cases, exploration combined with gauze tamponade in 1 case and ligation procedures with balloon tamponade in 3 cases. According to our results, haemostatic ligation procedures alone or combined with tamponade, have shown to be highly effective in 88,63%. Conclusion: Transvaginal approach for surgical treatment of lower uterine segment atony is accessible, feasible, successful and life saving. It can be easily performed in inpatient and outpatient care settings followed by administration of uterotonics, uterostiptics and tranexamic acid and fluid replacement. All of the above mentioned methods are of great importance in the prevention and treatment of obstetric hemorrhagic shock, development of coagulopathy, multiorgan failure, postpartum hysterectomy and finally vital for fertility preservation.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Early Postpartum Hemorrhage Caused by Lower Uterine Segment Atony

Habek¹,

Márton

Prka

et al. 2021

Preprint

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Section: Introductionmentioning

confidence: 92%

“…The success rates were not significantly different when these therapies were used after the failure of UTB. The study shows that even after these interventions, nearly one fourth of the women that had a hysterectomy for final control of the hemorrhage [15].Internal Iliac Artery Ligation has been defined as an efficient method to control untreatable PPH and prevention of maternal death. The justification for these stands on the Burchel hemodynamic studies that showed a 45% reduction on the pelvic blood flow and the pulse pressure on an 85%, which results in increase on the blood venous pressure in the arterial circuit promoting hemostasis.…”

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confidence: 99%

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Time Determination of Permanence of the Sengstaken Blakemore Ballon in Relation with the Clinical Outcome in Postpartum Hemorrhage Patients

Oviedo¹

2018

OGIJ

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Postpartum hemorrhage is one of the leading causes of maternal death in the world, representing the 27 %. More than two thirds of these cases have been classified as postpartum hemorrhage (PPH). The guidelines for the treatment of PPH implicate a step by step focus, initiating with the exclusion of retained placental tissue, genital tract trauma, uterine massage and multiple uterotonic agents. If bleeding control is not accomplished, it requires surgical intervention like compression sutures, internal iliac artery ligation and obstetric hysterectomy. Recently the balloon uterine tamponade has been added to the management of PPH. Here in the High Specialty Unit we use the Sengstaken Blakemore (SSB) balloon as uterine tamponade.Objectives: Comparing the time of the SSB balloon permanence in relation to the bleeding control success in postpartum hemorrhage patients. Methods:A comparative, retrospective and transversal analytical study will be carried out in patients that had there pregnancy terminated in this unit and was treated with SSB uterine tamponade.Results: Registries were obtained from 149 files from patients with PPH that were treated with SSB uterine tamponade in a period of time understood from 2013-2014, a success rate was found with SSB uterine tamponade of 92.62% (P=<0.001), it was estimated that over 20.5 hours (SEN 52.9%, SPE 77.2%) doesn't offer greater benefit carrying out the permanence of the SSB uterine tamponade, securely removing the tamponade at this time. Conclusion:The SSB uterine tamponade is being used in Monterrey, Nuevo Leon with a greater success rate than the one reported in literature; the age of the patient and the number of pregnancies are variables that can predict the probable success of the treatment, and that once installed the ideal time of permanence of the uterine tamponade can be less than 20.5 hours. guidelines for postpartum hemorrhage implicate a step by step focus, initiating with the exclusion of retained placental tissue and obstetrical trauma. Uterine Atony is treated with uterine massage and compression and multiple uterotonic agents such as oxytocin, ergonovine, misoprostol and F2 a Prostaglandins (PGF2a). If bleeding control is not accomplished, it requires surgical intervention like compression sutures, internal iliac artery ligation and obstetric hysterectomy. Recently the balloon uterine tamponade has been added to the management of PPH. Although Uterine Tamponade has recently been added to the management of PPH by the WHO in 2012 as a rescue intervention for PPH, it hasn't been integrated to the Health Systems Protocols [2]. In the majority of the Health Centers this procedure has been used before surgical interventions. Historically uterine tamponade was used with gauzes and compresses, but the technical difficulty of insertion and the risk of perforation, the SSB uterine tamponade have been favored by gynecologists. In various series of studies, it has been reported the successful use of a great variety of balloon devices, including the Sengstaken ...

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“…It refers to a condition where the volume of hemorrhage of puerpera exceeds 500 mL within 24 h after delivery of the fetus. Sometimes, the amount of hemorrhage of puerpera after cesarean delivery may be more than 1000 mL within 24 h, and the increased amount of hemorrhage may be accompanied by hypovolemia [3,4]. In addition, postpartum erythrocyte loss of up to, or more than 10 % is considered as postpartum hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Carboprost tromethamine prevents caesarean sectionassociated postpartum hemorrhage

Wang¹,

Jiang²,

Yang³

2020

Trop. J. Pharm Res

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Purpose: To investigate the effect of carboprost tromethamine on post-partum hemorrhage associated with caesarean section.Methods: One hundred patients with postpartum hemorrhage induced by cesarean section who were admitted to Binzhou People’s Hospital from October 2016 to August 2018 were selected. They were randomly assigned to two groups: control group and treatment group. Patients in the control group were administered oxytocin, while those in the treatment group received oxytocin in combination with carboprost tromethamine. The incidence of hemorrhage and adverse reactions were compared for the two groups.Results: The two groups showed gradually increasing degrees of postpartum hemorrhage within 24 h, but the treatment group had significantly lower volume of postpartum hemorrhage than the control group at different time points (p < 0.05). At the 1st, 3rd and 5th days after delivery, the height of the uterine fundus decreased gradually in the two groups, but was smaller in the treatment group than in the oxytocin group at all time points (p < 0.05). Total response in the treatment group was 98 %, which was significantly higher than 78 % in the control group (p < 0.05). The incidence of adverse reactions in the treatment group (12 %) was significantly lower than that in the control group (24 %, p < 0.05).Conclusion: Carboprost tromethamine prevents postpartum hemorrhage after cesarean section. It effectively reduces bleeding and promotes uterine involution, without obvious adverse reactions. Keywords: Carboprost tromethamine, Oxytocin, Cesarean section, Postpartum hemorrhage

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Double-balloon tamponade in the management of postpartum hemorrhage: a case series

Cited by 13 publications

References 8 publications

Surgical Treatment of Early Postpartum Hemorrhage Caused by Lower Uterine Segment Atony

Surgical Treatment of Early Postpartum Hemorrhage Caused by Lower Uterine Segment Atony

Time Determination of Permanence of the Sengstaken Blakemore Ballon in Relation with the Clinical Outcome in Postpartum Hemorrhage Patients

Carboprost tromethamine prevents caesarean sectionassociated postpartum hemorrhage

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