Initial experience with a dual-balloon catheter for the management of postpartum hemorrhage

Dildy, Gary A.; Belfort, Michael A.; Adair, Charles; Destefano, Kimberly; Robinson, Donna L.; Lam, Garrett; Strong, Thomas H.; Polon, Clive; Massaro, Robert; Bukkapatnam, Jayasri; Hook, James W. Van; Kassis, Iskander; Sunderji, Shiraz

doi:10.1016/j.ajog.2013.09.015

Cited by 100 publications

(42 citation statements)

References 12 publications

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“…With the Ebb balloon, which was employed in our case, the vaginal and uterine balloons are separate, which may be advantageous in inversion cases as the vaginal balloon may prevent the unintended expulsion of the uterine balloon and accordingly decreases the likelihood of reinversion. Although Dildy et al 9 recently documented the Ebb balloon's efficacy with respect to postpartum haemorrhage, to our knowledge, this is the first report of the balloon's use for the management of uterine inversion.…”

Section: Discussionmentioning

confidence: 75%

Intrauterine tamponade balloon use in the treatment of uterine inversion

Haeri

Rais

Monks³

2015

BMJ Case Reports

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Uterine inversion is a rare but life-threatening obstetrical emergency that occurs when the fundus of the uterus prolapses through the cervix, hence turning the uterus inside out. In this case report, we present our experience using an intrauterine tamponade balloon for management of uterine inversion, and a review of the literature. The utility of an intrauterine tamponade balloon in cases of uterine inversion, especially when maternal medical conditions preclude the use of uterotonics, or reinversion is observed should be kept in mind.

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Section: Discussionmentioning

confidence: 75%

Intrauterine tamponade balloon use in the treatment of uterine inversion

Haeri

Rais

Monks³

2015

BMJ Case Reports

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“…However, there have been no attempts to develop IBT systems for upper uterine cavity tamponade. A dual‐balloon catheter is commercially available, but the balloons are for the uterine cavity and for vagina, respectively . We previously reported that tandem placement of double balloons in the uterine cavity controlled atonic PPH with arterial bleeding from the upper uterine cavity by firm pressure onto the upper uterine cavity .…”

Section: Discussionmentioning

confidence: 99%

Novel intrauterine balloon tamponade systems for postpartum hemorrhage

Kondoh

Chigusa

Ueda

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Postpartum hemorrhage is the most common cause of maternal death worldwide. Although intrauterine balloon tamponade has been widely used as an effective procedure to control atonic postpartum hemorrhage, intrauterine balloon tamponade fails to control postpartum hemorrhage in approximately one‐fifth of cases. The aim of this study was to evaluate the efficacy of novel intrauterine balloon tamponade systems for postpartum hemorrhage. Material and methods We have developed two novel intrauterine balloon tamponade systems to maintain proper balloon placement. One was a shaft cover with its fixture system and the other was “the Kyoto balloon system” designed to provide direct pressure onto the upper uterine cavity. The efficacy of the intrauterine balloon tamponade systems was evaluated using a silicone three‐dimensionally printed postpartum uterine cavity model. Results Measurements of balloon displacement during inflation showed that the shaft cover significantly prevented the Bakri balloon from being displaced. The residual fluid volume in the upper uterine cavity was significantly less with the Kyoto balloon system than with the Bakri balloon system, indicating the effectiveness of the Kyoto balloon for upper uterine cavity tamponade. Conclusions These innovative intrauterine balloon tamponade systems were effective for prevention of balloon displacement and for balloon tamponade of the upper uterine cavity in a 3D‐printed postpartum‐specific uterine cavity model.

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“…In addition, although intrauterine balloon tamponade seems to be a readily available intervention of first choice in the management of persistent postpartum hemorrhage, it should not delay or be considered a replacement for uterine artery embolization or hysterectomy if that procedure is deemed necessary to control bleeding. On the other hand, intrauterine balloon tamponade could also be used as temporizing measure while awaiting embolization or surgery …”

Section: Discussionmentioning

confidence: 99%

Comparison of outcome between intrauterine balloon tamponade and uterine artery embolization in the management of persistent postpartum hemorrhage: A propensity score‐matched cohort study

Ramler

Henriquez

Akker

et al. 2019

Acta Obstet Gynecol Scand

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Introduction The aim of this study was to compare the outcomes of women who were initially managed by intrauterine balloon tamponade or uterine artery embolization because of persistent postpartum hemorrhage demanding an immediate intervention to control bleeding. Material and methods Propensity score‐matched cohort study including women who had intrauterine balloon tamponade or uterine artery embolization as initial management strategy to control persistent postpartum hemorrhage, that is, refractory to first‐line therapy combined with at least one uterotonic agent. The primary outcome measure was a composite of peripartum hysterectomy and/or maternal mortality. Secondary outcomes measures were total volume of blood loss and total number of packed red blood cells transfused. Results Our 1:1 propensity score‐matched cohort comprised of 50 women who had intrauterine balloon tamponade and 50 women who underwent uterine artery embolization at a blood loss between 1000 and 7000 mL. There was no statistically significant difference in the hysterectomy risk between the two groups (n = 6 in each group, odds ratio [OR] 1.00, 95% confidence interval [CI] .30‐3.34), in total volume of blood loss (median 4500 mL, interquartile range [IQR] 3600‐5400) for balloon vs 4000 mL (IQR 3250‐5000) for embolization, P = 0.382) or in total units of packed red blood cells transfused (median 7 (IQR 5‐10) for balloon vs 6 [IQR 4‐9] for embolization, P = 0.319). Fifteen women (30%) who were initially managed by an intrauterine balloon still underwent uterine artery embolization, of whom one had an embolization‐related thrombo‐embolic event. Maternal mortality occurred in neither of the intervention groups. Conclusions No difference in the risk of peripartum hysterectomy and/or maternal death was observed between women who had intrauterine balloon tamponade and women who underwent uterine artery embolization as an initial management for persistent postpartum hemorrhage. Although this study was underpowered to demonstrate equivalence, our study design provides a framework for future research in which intrauterine balloon tamponade may prove to be a suitable intervention of first choice in the management of persistent postpartum hemorrhage.

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Initial experience with a dual-balloon catheter for the management of postpartum hemorrhage

Cited by 100 publications

References 12 publications

Intrauterine tamponade balloon use in the treatment of uterine inversion

Intrauterine tamponade balloon use in the treatment of uterine inversion

Novel intrauterine balloon tamponade systems for postpartum hemorrhage

Comparison of outcome between intrauterine balloon tamponade and uterine artery embolization in the management of persistent postpartum hemorrhage: A propensity score‐matched cohort study

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