Intraluminal pressure of uterine balloon tamponade in the management of severe post-partum hemorrhage

2018 ◽  
Vol 44 (5) ◽  
pp. 914-921 ◽  
Author(s):  
Choi Wah Kong ◽  
William W. K. To
Keyword(s):  
Post Partum ◽  
Intraluminal Pressure ◽  
Post Partum Hemorrhage ◽  
Balloon Tamponade ◽  
Uterine Balloon Tamponade

scholarly journals Cost-effectiveness of uterine balloon tamponade devices in managing atonic post-partum hemorrhage at public health facilities in India

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256271
Author(s):  
Beena Nitin Joshi ◽  
Siddesh Sitaram Shetty ◽  
Kusum Venkobrao Moray ◽  
Oshima Sachin ◽  
Himanshu Chaurasia
Keyword(s):  
Public Health ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Incremental Cost ◽  
Post Partum ◽  
Public Health Facilities ◽  
Post Partum Hemorrhage ◽  
Balloon Tamponade ◽  
Uterine Balloon Tamponade

Objective Post-partum hemorrhage (PPH) is the leading direct cause of maternal mortality in India. Uterine balloon tamponade (UBT) is recommended for atonic PPH cases not responding to uterotonics. This study assessed cost-effectiveness of three UBT devices used in Indian public health settings. Methods A decision tree model was built to assess cost-effectiveness of Bakri-UBT and low-cost ESM-UBT alternatives as compared to the recommended standard of care i.e. condom-UBT intervention. A hypothetical annual cohort of women eligible for UBT intervention after experiencing atonic PPH in Indian public health facilities were evaluated for associated costs and outcomes over life-time horizon using a disaggregated societal perspective. Costs by undertaking primary costing and clinical parameters from published literature were used. Incremental cost per Disability Adjusted Life Years (DALY) averted, number of surgeries and maternal deaths with the interventions were estimated. An India specific willingness to pay threshold of INR 24,211 (USD 375) was used to evaluate cost-effectiveness. Detailed sensitivity analysis and expected value of information analysis was undertaken. Results ESM-UBT at base-case Incremental Cost-Effectiveness Ratio (ICER) of INR -2,412 (USD 37) per DALY averted is a cost-saving intervention i.e. is less expensive and more effective as compared to condom-UBT. Probabilistic sensitivity analysis however shows an error probability of 0.36, indicating a degree of uncertainty around model results. Bakri-UBT at an ICER value of INR -126,219 (USD -1,957) per DALY averted incurs higher incremental societal costs and is less effective as compared to condom-UBT. Hence, Bakri-UBT is not cost-effective. Conclusion For atonic PPH management in India, condom-UBT offers better value as compared to Bakri-UBT. Given the limited clinical effectiveness evidence and uncertainty in sensitivity analysis, cost-saving result for ESM-UBT must be considered with caution. Future research may focus on generating high quality comparative clinical evidence for UBT devices to facilitate policy decision making.

Balloon tamponade during cesarean section is useful for severe post-partum hemorrhage due to placenta previa

2011 ◽  
Vol 38 (1) ◽  
pp. 102-107 ◽  
Author(s):  
Takako Ishii ◽  
Kenjiro Sawada ◽  
Shunsuke Koyama ◽  
Aki Isobe ◽  
Atsuko Wakabayashi ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Post Partum ◽  
Post Partum Hemorrhage ◽  
Balloon Tamponade

657: Bakri balloon tamponade and uterine packing with gauze in post partum hemorrhage management: any differences?

2014 ◽  
Vol 210 (1) ◽  
pp. S322
Author(s):  
Luisa Patanè ◽  
Giorgia Cavalli ◽  
Valentina Mandelli ◽  
Nicola Strobelt ◽  
Luigi Frigerio ◽  
...  
Keyword(s):  
Post Partum ◽  
Post Partum Hemorrhage ◽  
Balloon Tamponade ◽  
Bakri Balloon

scholarly journals A study of the efficacy and safety of the balloon tamponade in the management of atonic post-partum hemorrhage

2020 ◽  
Vol 9 (4) ◽  
pp. 1576
Author(s):  
Aruna Kumar ◽  
Khushboo Kachchhap ◽  
Shubha Shrivastava
Keyword(s):  
Post Partum ◽  
Post Partum Hemorrhage ◽  
Medical College ◽  
Balloon Tamponade ◽  
Maternal Morbidity And Mortality ◽  
Different Types ◽  
One Year ◽  
Gandhi Medical College ◽  
Condom Catheter ◽  
Bakri Balloon

Background: The most common cause of post-partum hemorrhage (PPH) is uterine atony. Treatment for atony follows a well-defined stepwise approach, including drugs and mechanical interventions followed by surgery as a last resort. Early use of intrauterine balloon tamponade is a way of limiting ongoing uterine blood loss while initiating other measures and can be readily implemented by providers with minimal training.Methods: This prospective interventional study was conducted in 112 consecutive patients attended department of obstetrics and gynecology, Gandhi Medical College and Associated Sultania Zanana Hospital, Bhopal, Madhya Pradesh, India, in one year of study period.Results: In this study most of the patients had gestational age >37 weeks [83 (74.1%)]. Most of the patients in the study had vaginal delivery [64 (57.1%)]. In 84 (75%) patients Bakri balloon was used followed by Burke balloon in 17 (15.2%) patients, condom catheter in 7 (6.2%) patients and CG balloon in 4 (3.6%) patients. Different types of balloons were used according to availability of balloon at the time of management. Most of the patients [71 (63.3%)] had trans-vaginal route of balloon placement and 41 (36.7%) patients underwent trans-abdominal balloon placement. Most of the patients 69 (61.65%), responded to tamponing within 20 minutes of balloon placement while 9 patients had negative tamponade and continued to bleed. Bakri balloon tamponade was most commonly used in 84 (75.0%) patients. CG balloon and condom catheter were used only in 4 (3.6%) and 7 (6.3%) patients respectively. Tamponading was effective and successful in 103 (92%) patients.Conclusions: PPH is still a leading but preventable cause of maternal morbidity and mortality. In the majority of cases, relatively simple methods are used to avert a disaster, although these are not always employed. Uterine tamponade using intrauterine balloons appears to be an effective tool in the management of PPH.

scholarly journals Successful use of balloon tamponade in the management of postpartum hemorrhage in a case of bicornuate uterus

2018 ◽  
Vol 6 ◽  
pp. 2050313X1877617
Author(s):  
Erum Saleem Khan ◽  
Ayesha Basharat
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Incidental Finding ◽  
Post Partum ◽  
Successful Management ◽  
Clear Fluid ◽  
Bicornuate Uterus ◽  
Balloon Tamponade ◽  
Uterine Malformations ◽  
Uterine Balloon Tamponade

Worldwide 50%–70% of all cases of maternal morbidity have been attributed to postpartum hemorrhage. This report discusses a case of bicornuate uterus in a term pregnancy. The delivery was by cesarean section, which was followed by massive postpartum hemorrhage, managed successfully with balloon tamponade. This is the second reported case of successful management of post partum hemorrhage in a bicornuate uterus with balloon tamponade. A 22-year-old primigravida at 39 weeks of gestational age presented with vaginal leaking of clear fluid. Cesarean section was done due to meconium stained liquor in early labor; with an incidental finding of bicornuate uterus followed by massive postpartum hemorrhage managed successfully with balloon tamponade. The use of uterine balloon tamponade as an effective method to control postpartum hemorrhage has been studied extensively, but use in cases of hemorrhage associated with uterine malformations has not been reported much in literature. Use of uterine balloon tamponade in case of uterine malformations has been highlighted in our case as an effective non-surgical method to control hemorrhage.

scholarly journals A case series of post-partum haemorrhage managed using Ellavi uterine balloon tamponade in a rural regional hospital

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Gerhard B. Theron ◽  
Vulikaya Mpumlwana
Keyword(s):  
Post Partum ◽  
Case Series ◽  
Regional Hospital ◽  
Referral Hospital ◽  
Eastern Cape ◽  
Tertiary Referral Hospital ◽  
Balloon Tamponade ◽  
Nelson Mandela ◽  
Uterine Balloon Tamponade ◽  
Post Partum Haemorrhage

Uterine balloon tamponade (UBT) should be attempted once emergency measures have been applied and medical treatment for post-partum haemorrhage (PPH) resulting from an atonic uterus has failed. Sinapi Biomedical (Pty) Ltd developed the Ellavi UBT, a free-flow pressure-controlled UBT unit. The device is affordable for use in lesser-resourced countries. A case series of Ellavi UBT used by medical officers in a rural regional hospital without specialist supervision was conducted. This case series was conducted in St Elizabeth’s Hospital in Lusikisiki, South Africa. The hospital serves as the regional hospital for the Ingquza Hill Subdistrict in the Eastern Cape Province. The Nelson Mandela Academic Hospital (NMAH) in Mthatha is the tertiary referral hospital. Workshops were conducted on the use of Ellavi UBT, and devices were made freely available to the hospital. The case series included 10 patients. Six patients delivered by caesarean section, and four had normal vertex deliveries. All patients had additional oxytocin infusions, and eight patients received misoprostol. Following the insertion and inflation of the Ellavi UBT, the PPH stopped in seven patients, was much reduced in one patient and reduced in one patient. In one case, the Ellavi UBT had no effect on the bleeding. All 10 patients were referred to the NMAH. All patients in the case series had good outcomes. The insertion of the Ellavi UBT and subsequent referral proved to be feasible in a rural regional hospital. All patients included in the case series arrived at the referral hospital and had a good outcome.

Solution to Technical Difficulties of Uterine Balloon Tamponade Placement in Primary PPH Management: A Retrospective Case Series

2021 ◽  
Vol 15 (9) ◽  
pp. 2467-2469
Author(s):  
Noreen Nasim ◽  
Shazia Majid Khan ◽  
Ayesha Zafar ◽  
Sara Yousuf ◽  
Moeen Akhtar Malik
Keyword(s):  
Post Partum ◽  
Case Series ◽  
Hospital Data ◽  
Retrospective Case ◽  
Surgical Interventions ◽  
Balloon Tamponade ◽  
Retrospective Case Series ◽  
Gynecology And Obstetrics ◽  
Case Series Study ◽  
Uterine Balloon Tamponade

Objective: The aim of this study was to devise and enforce a simple yet effective method of condom placement for IUBT while dealing with all the technical difficulties in a poor resource setup to control primary PPH to save life of mother. Methodology: It is a retrospective case series study that is based on the hospital data obtained from Gynecology and Obstetrics Department of Sheikh Zayed Hospital, Rahim Yar Khan for a period of 8 months (July 2019 to Feb 2020) . Patients with persistent primary PPH after medical management who were given intra-uterine balloon tamponade (IUBT) were included in this study after evaluation for possible risk factors of PPH. Sample size was kept 30 with power of test at 80% and level of significance at 5%. Statistical assessment of the variables was done and the data was analyzed with SPSS v.21. Results: The 30 female patients, included in this study, had mean age of 30.3±6.06 years ranging from 17 to 39 years. Condom IUBT was successfully placed in 28(93.3%) patients by using 4 ring forceps applied on cervix and tied together with a gauze to keep the balloon in utero in order to control bleeding of PPH while in 2(6.66%) patients; it was unsuccessful due to inexperience of the operating staff. Out of these 28 patients with successful IUBT placement, condom based intra-uterine balloon tamponade was successful in controlling bleeding of PPH in 26(92.86%) patients while in 2(7.14%) patients, bleeding was not controlled and they underwent surgical interventions. Conclusion: Condom based Intra-uterine balloon tamponade is a simple yet effective method to control bleeding in primary postpartum hemorrhage but needs positive re-enforcement in the form of awareness/training sessions for the healthcare staff. Keywords: Catheter, Post-Partum Morbidity, Condom, Intra-Uterine Balloon Tamponade, Hemorrhage, Hysterectomy

scholarly journals Healthcare providers experiences of using uterine balloon tamponade (UBT) devices for the treatment of post-partum haemorrhage: A meta-synthesis of qualitative studies

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248656
Author(s):  
Kenneth Finlayson ◽  
Joshua P. Vogel ◽  
Fernando Althabe ◽  
Mariana Widmer ◽  
Olufemi T. Oladapo
Keyword(s):  
Post Partum ◽  
Healthcare Providers ◽  
Cost Effective ◽  
Successful Implementation ◽  
Middle Income ◽  
Medical Treatments ◽  
Middle Income Countries ◽  
Balloon Tamponade ◽  
Cost Effective Approach ◽  
Uterine Balloon Tamponade

Background Postpartum haemorrhage (PPH) is a leading cause of maternal mortality and severe morbidity globally. When PPH cannot be controlled using standard medical treatments, uterine balloon tamponade (UBT) may be used to arrest bleeding. While UBT is used by healthcare providers in hospital settings internationally, their views and experiences have not been systematically explored. The aim of this review is to identify, appraise and synthesize available evidence about the views and experiences of healthcare providers using UBT to treat PPH. Methods Using a pre-determined search strategy, we searched MEDLINE, CINAHL, PsycINFO, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996–2019, reporting qualitative data on the views and experiences of health professionals using UBT to treat PPH. Author findings were extracted and synthesised using techniques derived from thematic synthesis and confidence in the findings was assessed using GRADE-CERQual. Results Out of 89 studies we identified 5 that met our inclusion criteria. The studies were conducted in five low- and middle-income countries (LMICs) in Africa and reported on the use of simple UBT devices for the treatment of PPH. A variety of cadres (including midwives, medical officers and clinical officers) had experience with using UBTs and found them to be effective, convenient, easy to assemble and relatively inexpensive. Providers also suggested regular, hands-on training was necessary to maintain skills and highlighted the importance of community engagement in successful implementation. Conclusions Providers felt that administration of a simple UBT device offered a practical and cost-effective approach to the treatment of uncontrolled PPH, especially in contexts where uterotonics were ineffective or unavailable or where access to surgery was not possible. The findings are limited by the relatively small number of studies contributing to the review and further research in other contexts is required to address wider acceptability and feasibility issues.

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