ResearchObstetricsThe combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage
Section snippets
Methods
This is a retrospective study of consecutive patients diagnosed to have a severe PPH and unsuccessful medical treatment with uterotonic agents who were subsequently treated with the Bakri balloon in our unit between January 2005 and July 2010. The cases were identified by review of medical records. This case series includes all cases of PPH managed with the uterine balloon tamponade (Bakri SOS balloon; Cook Woman's Health, Spencer, IN) after its introduction in our department in 2005. After
Results
During the study period, there were 9838 deliveries and the incidence of severe PPH unresponsive to standard medical treatment was 0.24% (n = 24/9838). The Bakri balloon tamponade was used in 20 cases (0.2% of all deliveries). The Table summarizes the clinical characteristics of the patients included in this report.
Estimated blood loss ranged from 800-8000 mL (median 2000) and patients received a median of 2.5 units of packed red blood cells (range, 0–26) and a median of 1 unit of fresh frozen
Comment
This study shows, that the Bakri balloon alone or in combination with B-Lynch sutures was effective in avoiding hysterectomy in 90% of cases with severe PPH, after cesarean section as well as after vaginal delivery.
Balloon tamponade may avoid the necessity for laparotomy after vaginal delivery as previously described.10 Even in those cases in which treatment with the Bakri balloon was unsuccessful, it did not result in a significant delay to the operating room and allowed enough time to
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Traditional uterine tamponade and vacuum-induced uterine tamponade devices in obstetrical hemorrhage management
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2022, Best Practice and Research: Clinical AnaesthesiologyCitation Excerpt :If this approach fails, radiological intervention or abdominal surgery should be performed without delay. For cesarean section, compression sutures should be considered rather than a uterine balloon, but both techniques can also be performed simultaneously [101–103]. For unstoppable bleeding, damage control surgery is mandatory as described below.
Uterine balloon tamponade for the treatment of postpartum hemorrhage: a systematic review and meta-analysis
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2018, Journal of Obstetrics and Gynaecology CanadaFIGO good practice recommendations on surgical techniques to improve safety and reduce complications during cesarean delivery
2023, International Journal of Gynecology and ObstetricsPeripartum Haemorrhage, Diagnosis and TherapyGuideline of the DGGG, OEGGG and SGGG (S2k, AWMF Registry No. 015-063, August 2022)
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The authors report no conflict of interest.
Reprints not available from the authors.
Cite this article as: Diemert A, Ortmeyer G, Hollwitz B, et al. The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage. Am J Obstet Gynecol 2012;206:65.e1-4.