Uterine Balloon Tamponade in Management of Postpartum Hemorrhage

Abstract

Aim. To evaluate the efficacy and safety of uterine balloon tamponade for the management of postpartum haemorrhage.Materials and Methods. We have screened the Cochrane Library and PubMed for the following keywords: “intrauterine balloon tamponade”, “controlled balloon tamponade”, “controlled balloon tamponade” AND “postpartum bleeding/haemorrhage” during 5 years (2018-2023). In total, we have identified 358 publications including 3 meta-analyses, 6 systematic reviews, and 13 randomized controlled trials. After checking titles and abstracts to remove duplicates, we selected 38 sources which met the selection criteria.Results. Postpartum haemorrhage remains the leading cause of maternal mortality in both developing and developed countries. In most cases, postpartum haemorrhage occurs due to atony and is controlled by administration of uterotonics. However, if uncurbed, postpartum haemorrhage requires blood transfusion and surgery. Currently, uterine balloon tamponade is considered as one of the most efficient and safe technologies for controlling postpartum haemorrhage and preventing hysterectomy, yet a number of studies have reported negative results. Several investigations showed an advantage of double-balloon tamponade as it provides an additional benefit of vascular compression of the lower uterine segment. Generally, uterine balloon tamponade is an efficient intervention which allows to avoid additional surgeries (uterine artery embolization or hysterectomy) in 87.3 – 100.0% of cases with a relatively low complication rate (< 6.7% – 9.4%).Conclusion. The effectiveness of uterine balloon tamponade and the risk of complications are probably determined by the type of device, the learning curve effect, and the regularity and quality of training of medical personnel. Further in-depth multicenter studies in this direction are required.