The fertility sparing management of postpartum hemorrhage: A series of 47 cases of Bakri balloon tamponade

• Published in: Taiwanese journal of obstetrics & gynecology Vol. 54; no. 3; pp. 232 - 235
• Main Authors: Alkış, İsmet, Karaman, Erbil, Han, Agahan, Ark, Hasan Cemal, Büyükkaya, Betül
• Format: Journal Article
• Language: English
• Published: China (Republic : 1949- ) Elsevier B.V 01.06.2015; Elsevier
• Subjects: Adolescent; Adult; Bakri balloon; Cesarean Section; Female; Fertility Preservation - methods; Humans; Hysterectomy; Internal Medicine; Labor, Induced; Middle Aged; Obstetrics and Gynecology; Organ Sparing Treatments; postpartum hemorrhage; Postpartum Hemorrhage - etiology; Postpartum Hemorrhage - surgery; Postpartum Hemorrhage - therapy; Pregnancy; Retreatment; Retrospective Studies; Treatment Failure; Uterine Balloon Tamponade; uterine tamponade; Young Adult; postpartum hemorrhage; Bakri balloon; uterine tamponade
• ISSN: 1028-4559; 1875-6263
• DOI: 10.1016/j.tjog.2014.03.009

Abstract Objective To evaluate the success rate of Bakri balloon tamponade (BBT) for managing postpartum hemorrhage (PPH), intractable to conservative medical treatment, as a fertility sparing intervention. Materials and methods We evaluated 47 women treated with BBT who had severe postpartum hemorrhage and uncontrollable bleeding due to failed treatment with uterotonic agents. The main outcome measure was successful management and preservation of the uterus. Results Forty-seven women were identified for BBT treatment due to severe PPH. BBT was used to successfully manage hemorrhage in 43 patients, and there was no need for hysterectomy. Four patients required an additional surgical procedure. Of the four failures, a subtotal hysterectomy was performed in two patients, and the other two patients underwent a total hysterectomy. The overall success rate was 91.4%, which was comparable to rates reported earlier. The main cause of PPH was uterine atony (43%). Conclusion Uterine preservation is an important issue when managing PPH. BBT is an effective, easy to use, and safe procedure for massive PPH that can minimize recourse to hysterectomy after failed medical treatment.