Intra uterine condom balloon tamponade-a life saving measure in atonic pph

Abstract

Material & methods-Thirty women having atonic PPH in whom active management of third stage of labour and uterotonics were not effective, were selected for this study. With full aseptic and antiseptic precautions a condom was tied on a nasogastric tube and was inserted into the uterine cavity, the distal end of the tube was connected to an IV set through which 250-500cc normal saline was instilled to inflate the condom so as to achieve haemostasis. Observation-46.6% women were between 25-30 yrs of age, 53.3% were multigravida. The gestational age was between 37-40 weeks in 80% cases. In 53.3% cases, there was some associated risk factor for PPH. In 72.72% cases placenta took alonger time to separate. In 66.6% women 250-500ml saline was instilled to inflate the condom balloon. It took 10-15 minutes time from insertion of the condom balloon catheter to achieve haemostsis in 73.3% women. The condom balloon catheter was kept in situ for 12-24 hrs in 73% women. Success rate of balloon tamponade was 90%. There was no infection in any case. Conclusion-Intrauterine condom balloon tamponade is effective, cheap and requires little skill. It can be used as a second line intervention in the management of atonic PPH. Skilled birth attendants in remote areas can use this technique and then transfer the woman to tertiary care unit. This will help in saving many maternal lives.