Maternal outcomes after uterine balloon tamponade for postpartum hemorrhage

Author:

Martin Emmanuelle1,Legendre Guillaume1,Bouet Pierre‐Emmanuel1,Cheve Marie‐Therese2,Multon Olivier3,Sentilhes Loïc1

Affiliation:

1. Department of Obstetrics and Gynecology Angers University Hospital Angers France

2. Department of Obstetrics and Gynecology Le Mans General Hospital Le Mans France

3. Department of Obstetrics and Gynecology Atlantic Polyclinic Saint‐Herblain France

Abstract

AbstractObjectiveTo evaluate maternal outcomes following uterine balloon tamponade in the management of postpartum hemorrhage.DesignRetrospective case‐series.SettingTwo French hospitals, a level 3 university referral center and a level 2 private hospital.PopulationAll women who underwent balloon tamponade treatment for primary postpartum hemorrhage.MethodsUterine tamponade was used after standard treatment of postpartum hemorrhage had failed. The study population was divided into two groups, successful cases where the bleeding stopped after the balloon tamponade, and failures requiring subsequent surgery or embolization.Main outcome measuresSuccess rates.ResultsUterine tamponade was used in 49 women: 30 (61%) after vaginal delivery and 19 (39%) after cesarean section. Uterine atony was the main cause of hemorrhage (86%). The overall success rate was 65%. Of 17 failures, surgery was required in 16 cases, including hysterectomy in 11, and uterine artery embolization in one case. Demographic and obstetric characteristics did not differ significantly between the success and failure groups. No complications were directly attributed to the balloon tamponade in the postpartum period. Two women had a subsequent full‐term pregnancy without recurrence of postpartum hemorrhage.ConclusionsBalloon tamponade is an effective, safe and readily available method for treating primary postpartum hemorrhage and could reduce the need for invasive procedures.

Publisher

Wiley

Reference31 articles.

1. Report of the National Experts' Committee on Maternal Mortality 2001–2006. December 2006. Available online at:http://www.invs.sante.fr/publications/2010/mortalite_maternelle/rapport_mortalite_maternelle_anglais.pdf(accessed 19 January 2010).

2. Questions abordées et méthodologie utilisée dans les recommandations pour la pratique clinique du CNGOF sur les hémorragies du post-partum (décembre 2004)

3. Systematic Review of Conservative Management of Postpartum Hemorrhage: What to Do When Medical Treatment Fails

4. Balloon tamponade in the management of postpartum haemorrhage: a review

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