Identifying Condom Catheter Component to Optimize Its Function As Intrauterine Balloon Tamponade (Iubt): A Laboratory Test

Abstract

Uterine atony is the primary cause of postpartum hemorrhage worldwide. Further management for severe bleeding or limited uterotonic is the insertion of intrauterine balloon tamponade (IUBT), and a modified condom catheter is the most affordable form of IUBT. However, it has some limitations that can emerge from the component of the tools. This study aims to identify the equipment component of the condom catheter and discover potential improvements to optimize its function as IUBT. Preclinical research under laboratory environmental conditions was conducted. Five condom types, six catheter sizes, and a type of macro drip IV tubing were included in the study. The specifications of all condoms were almost similar and did not significantly differ in capacity, shape, and leakage. The condom shapes were more rounded and had a high possibility of filling the uterine space entirely if tied in the middle instead of close to the tip based on the standard. There was no significant time difference (p = 0.111; CI95% 3.31–3.52) in draining the fluid when using large catheters (nos 18F, 20F, 22F, and 24F) and removing the catheter. However, not using a catheter should consider the device's required length and mother's comfort in early mobilization. Also, further clinical studies are highly recommended.

The effectiveness of using uterine tampons in treating uterine atony

“…World Health Organization (WHO) recommends the use of balloon catheters because their use has been proven to be simple, effective, and cheap. Muchlis et al (2021), stated that catheter condoms require a longer time than Bakri balloons to achieve hemostatic conditions. How to use it is: (1) label each condom, (2) insert the catheter into the condom, (3) tie the condom to the catheter using a 10 cm string at 3 cm from the end of the condom, (4) connect the catheter to the macro IV infusion tube and infusion bottle, (5) placing the condom on a flat table, (6) simultaneously administering the fluid infusion by releasing the clamp, (7) starting a fluid infusion of 500 mL to a maximum volume of 5000 mL (based on theory), (8) leaving it for 2 x 24 hours (Muchlis et al, 2021).…”