The association between intrauterine balloon tamponade volume and postpartum hemorrhage outcomes

Park, Ji Eun; Park, Ji Kwon; Jo, Hyen Chul; Cho, In Ae; Baek, Jong Chul

doi:10.1002/ijgo.13069

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…IUBT can be used as a temporary hemostatic measure until other treatment measures are prepared, even if the final treatment is ineffective. The present study found a correlation between higher prenatal hemoglobin levels and good outcomes in PPH patients treated with IUBT, which was consistent with previous research (15). To reduce the morbidity associated with PPH, the Royal College of Obstetricians and Gynecologists published guidelines in 2016 recommending that antenatal anemia be investigated and treated appropriately (2).…”

Section: Discussionsupporting

confidence: 90%

Differential Effects of Intrauterine Balloon Tamponade Indications on Postpartum Hemorrhage Outcomes

Chen

Wen

et al. 2022

Front. Med.

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ObjectiveTo determine whether the indication of intrauterine balloon tamponade (IUBT) was associated with postpartum hemorrhage (PPH) outcomes.MethodsPatients with PPH who underwent IUBT between January 2013 and November 2021 were included in a cohort study. PPH outcomes in patients who had IUBT for indications of uterine atony were compared to those who had IUBT for indications of placental site bleeding. PPH outcomes included uterine artery embolization (UAE) or hysterectomy after IUBT, estimated blood loss (EBL) after balloon placement, and blood transfusion. Statistical analysis was performed using multivariate logistic regression.ResultsIUBT was performed on 603 cases, with 121 (20.1%) undergoing it for placental site bleeding and 482 (79.9%) for uterine atony. In general, IUBT was a reliable treatment for PPH, but the specific efficacy varied depending on the indication for placement. After controlling for confounding variables, compared to the indication of uterine atony, the indication of placental site bleeding increased the risk of transfusion of ≥4 units of PRBCs (aOR 2.47, 95%CI 1.32–3.98), EBL ≥ 300 ml after IUBT (aOR 3.78, 95%CI 2.22–5.33), and UAE or hysterectomy (aOR 2.52, 95%CI 1.20–6.01), respectively. Other factors associated with adverse PPH outcomes were lower antenatal hemoglobin, higher IUBT volume, longer duration of IUBT and larger shock index values.ConclusionsIUBT was less effective in treating PPH patients with indications of placental site bleeding than with indications of uterine atony. Follow-up monitoring of PPH patients with placental site bleeding should be intensified.

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Section: Discussionsupporting

confidence: 90%

Differential Effects of Intrauterine Balloon Tamponade Indications on Postpartum Hemorrhage Outcomes

Chen

Wen

et al. 2022

Front. Med.

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“…Antibiotic prophylaxis (cephalosporin) and maintenance dose oxytocin should be administered throughout the tamponade time. (6,22,23,(25)(26)(27) After the infusion, the evaluation of the tamponade test begins. If within 30 minutes of infusion the drainage shows less than 50 mL, the prediction of successful tamponade is considered positive.…”

Section: When and How To Use An Intrauterine Balloon Tamponade?mentioning

confidence: 99%

Postpartum hemorrhage: prevention, diagnosis and non-surgical management

Alves

Francisco

Osanan

et al. 2020

Rev Bras Ginecol Obstet

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Change in uterine artery blood flow with intrauterine balloon tamponade

Shimaoka,

Shiga,

Morishige

2021

Clin. Exp. Obstet. Gynecol.

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The purpose of this study was to investigate the change in uterine artery blood flow in cases of intrauterine balloon tamponade (IBT). This was a retrospective cross-sectional study of 132 patients who underwent singleton cesarean section. IBT was performed in 35 of the 132 patients. There were 21 cases of placental mediated pregnancy complications (PMPC), which were not included in the IBT group. Placental positional abnormalities were significantly more common in the IBT group than in the control group (89% vs. 9%, P < 0.001). Multivariate analysis identified PMPC as a factor affecting the immediate preoperative uterine artery pulsatility index (UtA-PI). Finally, PMPC was excluded and we assessed 35 and 76 patients assigned to the IBT and control groups, respectively. We compared changes in uterine artery blood flow with and without IBT and by balloon volume. In the IBT group, the immediate pre- and postoperative UtA-PIs were significantly lower (0.56 ± 0.18 vs. 0.63 ± 0.15, P = 0.011, statistical power = 0.577) and higher (1.37 ± 0.66 vs. 0.96 ± 0.28, P < 0.001, statistical power = 0.986), respectively, than those in the control group. The immediate postoperative UtA-PIs depending on balloon expansion volume were 1.13 ± 0.60, 1.24 ± 0.57, and 1.71 ± 0.75, with balloon volumes of 100–199 mL, 200–299 mL, and 300–399 mL, respectively. In summary, IBT during cesarean section increases the immediate post-operative UtA-PI, and tends to increase with increase in balloon volume.

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The association between intrauterine balloon tamponade volume and postpartum hemorrhage outcomes

Cited by 3 publications

References 14 publications

Differential Effects of Intrauterine Balloon Tamponade Indications on Postpartum Hemorrhage Outcomes

Differential Effects of Intrauterine Balloon Tamponade Indications on Postpartum Hemorrhage Outcomes

Postpartum hemorrhage: prevention, diagnosis and non-surgical management

Change in uterine artery blood flow with intrauterine balloon tamponade

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