Predictors of failed intrauterine balloon tamponade for persistent postpartum hemorrhage after vaginal delivery

Grange, Joséphine; Chatellier, M.; Cheve, Marie-Thérèse; Paumier, Anne; Launay-Bourillon, Claudine; Legendre, Guillaume; Marion, Olivier; Ducarme, Guillaume

doi:10.1371/journal.pone.0206663

Cited by 20 publications

(17 citation statements)

References 21 publications

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“…Women with persistent postpartum hemorrhage may develop coagulopathy with blood loss, dilution, and consumption of platelets and coagulation factors, requiring high rates of blood transfusions. Previous studies have shown that EBL before IUBT is associated with IUBT failure (8,11,20), with an odds ratio for EBL before IUBT (>1,500 ml) of 3.2 (8). Howard and Grobman (21) reported that women receiving IUBT at higher EBL quartiles had more frequent packed red blood cell transfusions and more hysterectomies.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Failed Intrauterine Balloon Tamponade in the Management of Severe Postpartum Hemorrhage

et al. 2021

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To identify the factors predicting intrauterine balloon tamponade (IUBT) failure for severe postpartum hemorrhage (PPH) after delivery, we conducted a retrospective cohort study of women who underwent IUBT for severe PPH after delivery from October 1, 2016 until September 30, 2017. The failure of IUBT was defined as the need of additional surgical procedures or uterine embolization. A total of 99,650 deliveries occurred during the study period. Among the patients, 106 cases of severe PPH were managed with IUBT, and the global success rate was 70.8% (75/106). Least absolute shrinkage and selection operator (LASSO) regression was performed to select the potential risk factors predicting IUBT failure. The associated risk factors—obesity, multiple gestation, cesarean delivery, estimated blood loss (EBL), and placenta accreta spectrum (PAS)—were included in multivariate logistic models. Ultimately, these models identified multiple gestation, EBL, and PAS as independent risk factors for IUBT failure. In conclusion, IUBT is an effective method for severe PPH. The presence of factors affecting IUBT failure should be recognized early, and other modalities of management should be anticipated.

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Section: Discussionmentioning

confidence: 99%

Predictors of Failed Intrauterine Balloon Tamponade in the Management of Severe Postpartum Hemorrhage

et al. 2021

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“…The initial screening identified 43 articles as duplicates, letters, or editorials or as unrelated to the management of PPH with BBT. Of a total of 90 studies that were retrieved to assess eligibility, five were selected as relevant [ 20 , 21 , 22 , 23 , 24 ]. A flowchart for study selection is presented in Figure 2 .…”

Section: Resultsmentioning

confidence: 99%

“…The most common cause of PPH was uterine atony (50%), followed by placenta previa (28.1%). Two studies only included patients with placenta previa and caesarean delivery (21–22), and 1 study that only included patients with vaginal delivery [ 24 ]. The global success rate for BBT was 79.5%.…”

Section: Resultsmentioning

confidence: 99%

“…Since it was first described in 2001 [ 19 ], case series have reported high clinical success rates of BBT in PPH with good clinical outcomes, and various studies have analysed the risk factors associated with balloon failure. However, very few studies have performed a multivariate analysis that weights the effect of each factor in the presence of the others [ 20 , 21 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Failure of Bakri Balloon Tamponade for the Management of Postpartum Haemorrhage. Case Series Study and Systematic Review

et al. 2021

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Background: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Bakri balloon tamponade (BBT) is recommended when PPH does not respond to medical treatment. Nowadays few published studies have performed a multivariate analysis to determine the variables independently associated with BBT failure. Methods: Our study purpose was to determine the variables independently associated with BBT failure: first, in a large single-centre cohort study between 2010 and 2020, and second, in a systematic literature review using Medline and the Cochrane Library. Maternal and perinatal variables, PPH characteristics, technique-related variables and complications were recorded in the case series study, comparing between successful and failed BBT patients. Study characteristic and variables significantly associated with BBT failure were recorded in the systematic review. All studies used a logistic regression test. Results: The case series included 123 patients. The profile of these patients were primiparous, with vaginal delivery and a full-term new-born. BBT was successful in 81.3% of cases. Five studies were included in the systematic review, providing data from 551 patients. BBT was successful in 79.5% of cases. Conclusions: Maternal age, caesarean delivery, ≥7 red blood cells units (RBCU) transfused and curettage before BBT insertion, history of caesarean section, pre-pregnancy obesity, anteriorly placed placenta, placenta accreta, caesarean delivery, estimated blood loss before insertion of BBT, long operation duration, and coagulopathy were independent factors for BBT failure.

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“…In 2018, Grange et al examined the predictors of failed IUBT for persistent PPH after vaginal delivery (25). They reported that body mass index, labour duration, estimated blood loss and more than four packed of erythrocyte transfusion were statistically significant in predicting the failure of IUBT.…”

Section: Discussionmentioning

confidence: 99%

Bakri balonun 12 saatten daha uzun süre uygulanması postpartum uterus atonisi tedavisinde olumlu klinik sonuçlar sağlar mı?

Oğlak

Obut

2020

Ege Tıp Dergisi

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Aim: If the initial treatment techniques fail, intrauterine balloon tamponade (IUBT) devices such as Bakri balloon tamponade (BBT) is an effective treatment for reducing the bleeding in uterine atony patients. However, the duration of the Bakri balloon varies widely in clinical practice, and there is no consensus in this issue. This study aimed to compare the clinical outcomes of the Bakri balloon removed in less or more than 12 hours in patients with severe postpartum haemorrhage (PPH). Materials and methods: This retrospective study included 108 patients who underwent Bakri balloon for severe PPH after vaginal delivery. Patients were divided into two groups as the duration of Bakri balloon 8-12 hours (Group I) and >12 hours (Group II). BBT was considered to be successful if the bleeding was stopped, and the patient did not require additional invasive procedures. Age, parity, gestational week, cause of bleeding, presence of co-morbidity that may increase bleeding (multiple gestation, magnesium sulphate infusion), estimated blood loss (EBL) before and after Bakri balloon, postpartum infection, erythrocyte and fresh frozen plasma requirement and invasive procedure requirement of the groups were compared. Results: In group I, 26 patients (52%) underwent erythrocyte transfusion, and 18 patients (36%) underwent both erythrocyte and fresh frozen plasma (FFP) transfusion. In group II, 28 patients (41.2%) underwent erythrocyte transfusion, and 21 patients (30.9%) underwent both erythrocyte and FFP transfusion. These differences were not statistically significant (p=0.42 and p=0.21, respectively). Bacri balloon was failed to reduce bleeding in one patient (2%) in group I and one patient (1.5%) in group II, and these patients had to undergo invasive surgical procedures (hysterectomy). There was no statistically significant difference between the groups in terms of failed to reduce bleeding rates (p=0.52). Conclusion: Keeping the Bakri balloon in place for longer than 12 hours does not provide favourable clinical outcomes compared to keeping in place for less than 12 hours.

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Predictors of failed intrauterine balloon tamponade for persistent postpartum hemorrhage after vaginal delivery

Cited by 20 publications

References 21 publications

Predictors of Failed Intrauterine Balloon Tamponade in the Management of Severe Postpartum Hemorrhage

Predictors of Failed Intrauterine Balloon Tamponade in the Management of Severe Postpartum Hemorrhage

Factors Associated with Failure of Bakri Balloon Tamponade for the Management of Postpartum Haemorrhage. Case Series Study and Systematic Review

Bakri balonun 12 saatten daha uzun süre uygulanması postpartum uterus atonisi tedavisinde olumlu klinik sonuçlar sağlar mı?

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