Intrauterine balloon tamponade in the management of severe postpartum hemorrhage: A case series from a busy UK district general hospital

Tirumuru, Sahithi; Saba, Samiramis; Morsi, Hassan; B, Muammar

doi:10.4236/ojog.2013.31a025

Cited by 13 publications

(15 citation statements)

References 14 publications

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“…The appropriateness of response within 10 minutes of the onset of PPH has been shown to be critical to ensuring a successful outcome and minimizing adverse events with 80 percent of the deaths are clearly avoidable. [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Glove Tamponade for Atonic Postpartum Haemorrhage using Glove band

Hs¹,

Ram²

2014

IOSRJDMS

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Introduction: Balloon tamponade is effective and recently included in armamentarium of management of PPH. Condom tamponade is also popular and widely used in low resource setting. We introduced in this study, tamponade with glove and glove band using the same principles. Methods: Tamponde with glove using both pneumatic and hydrostatic method was studied in 2 cases. Glove bands are used to tie the gloves to Ryles tube with stillette inside which was used for inflation and facilitate placement. The device appears similar to uterine thermal balloon. After inflation When tamponade test was positive, the vagina was packed and Ryles tube with stillete is folded and strapped at the introitus. Drainage channel was attached to glove end. Double glove was used in pneumatic tamponade. Stethoscope tubing was used as y-connector with dial pressure meter and BP apparatus inflator. Results: Hemostasis was achieved in all 2 cases. The device could be placed successfully and immediately after opening the prepared kit and there was no incidence of air or saline leak and no popping-out /prolapse or bursting of the glove. There were no complications or mortaliy. Conclusion: Hydrostatic tamponade needs longer time especially when double gloves are used. Single glove serves the purpose well. The action of pneumatic glove tamponade is effective and instantaneous. We recommend this when the blood loss is marked in atonic PPH and there is lack of time. The device is simple, cheap, made with easily available materials and can be safely applied. Glove band prevents leakage of saline as well as air effectively without occlusion of the ryles tube lumen.

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Section: Discussionmentioning

confidence: 99%

Glove Tamponade for Atonic Postpartum Haemorrhage using Glove band

Hs¹,

Ram²

2014

IOSRJDMS

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“…5 Different reports have shown that uterine atony is the most common cause of PPH. 5,10,11 Agents which are helpful in improving uterine tone and uterine smooth muscle contractility are reported to be the choice of management option. World Health Organization (WHO) has recommended the use of prophylactic uterotonic drugs during the 3 rd stage of labor along with oxytocin (IM/IV, 10 IU).…”

Section: Discussionmentioning

confidence: 99%

Prospective study of various methods used in the management of post partum haemorrhage

2020

IJOGR

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Introduction: Mismanagement of postpartum haemorrhage (PPH) is the major reason for the maternal morbidity and mortality throughout the world, highest incidence is found in developing countries. Aims and objective: To study the various methods used to control PPH in all the deliveries that took place at the study place. Materials and Methods: Prospective study was performed on 402 PPH patients in the Department of Obstetrics and Gynecology, Kamla Raja Hospital, GR Medical College, Gwalior from Sept., 2014 to Aug., 2015. All the patients were divided in to atonic PPH and traumatic PPH. Patient's detailed history including obstetric history, menstrual history and history of drug allergy were recorded in pre-approved excel format. Patients were managed either by catheterization and uterine massage, using uterotonic drugs, uterine packing and surgical intervention such as internal iliac ligation and/or hysterectomay. Results: Out of total 7977 deliveries, 62.09% were vaginal and 37.91% were caesarean section. Out of that 402 (5.03%) developed PPH. Mean age of study population was 23.3±1.37 years. Out of 402 PPH patients, 75% were having atonic PPH whereas 19.65% were having traumatic PPH. Most of the patients with atonic PPH were managed by uterotonic drugs (69%) followed by cathererization with uterine massage (25%). Most of the patients with traumatic PPH were found to be due to hematoma or tear and were managed by haematoma drainage (58%) followed by perineal with vaginal repair (33%). Conclusion: Uterotonic drugs were the most commonly used for the management of atonic PPH whereas haematoma drainage was mostly used in patients with traumatic PPH.

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“…16 Balloon tamponade was effective in 41 of 47 cases (87.2%) of PPH from different causes such as uterine atony, placenta previa, and placental bed bleeding without further intervention. It was effective in avoiding hysterectomy in 93.6% women.…”

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confidence: 93%

Paracervical clamps for treatment of uncontrolled postpartum haemorrhage: a novel technique

Ramalingappa

Sireesha

2018

Int J Reprod Contracept Obstet Gynecol

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Background: PPH is one of the most dreaded third stage complication and is one of the leading cause of maternal mortality and morbidity. Most of the deaths are due to limited availability of pharmacological agents and absent skills to manage PPH. The basis of the study is to introduce a novel technique of application of paracervical clamps transvaginally for temporary occlusion of uterine arteries which represent 90% of blood flow to the uterus.Methods: A prospective study of patients with PPH who did not respond to medical management and who were hemodynamically stable. Paracervical clamps were applied and hemodynamic parameters are continuously monitored. Close monitoring for bleeding PV is done. Clamps are left intact for 6-8 hours and removed.Results: Out of 680 cases of Post-partum haemorrhage. Paracervical clamps were applied to 320 patients from duration of 2013 to 2015 in Karnataka Institute of Medical Sciences and Sushruta Multispeciality Hospital Hubballi. Haemorrhage was effectively controlled in 304 (95.1%) patients and only 16 patients required further surgical management. This non-invasive simple procedure has reduced the rates of surgical management of PPH and the associated morbidity.Conclusions: Application of paracervical clamps is an effective, simple and minimally invasive surgical technique for avoiding excess blood loss in mild to moderate postpartum haemorrhage.

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Intrauterine balloon tamponade in the management of severe postpartum hemorrhage: A case series from a busy UK district general hospital

Cited by 13 publications

References 14 publications

Glove Tamponade for Atonic Postpartum Haemorrhage using Glove band

Glove Tamponade for Atonic Postpartum Haemorrhage using Glove band

Prospective study of various methods used in the management of post partum haemorrhage

Paracervical clamps for treatment of uncontrolled postpartum haemorrhage: a novel technique

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