scholarly journals Effectiveness of the Intrauterine Compression Balloon in Postpartum Hemorrhage, Riobamba Provincial Teaching Hospital – October 2015 to September 2016

Author(s):  
Lino Arturo Rojas Pérez ◽  
Lino Arturo Rojas Cruz ◽  
María Daniela Villagómez Vega ◽  
Augusto Ernesto Rojas Cruz ◽  
Andrés Eduardo Rojas Cruz

  Introduction: Postpartum hemorrhage is blood loss greater than 500 mL after a normal delivery or more than 1000 mL after a cesarean section, or any postpartum bleeding regardless of the amount causing hemodynamic instability. The uterine blood flow in a term pregnancy is approximately 500 to 700 mL/min, for this reason, a patient who presents this complication, in a few minutes, can be drained and compromise her life. Objective: To determine the efficacy of the intrauterine compression, balloon in the management of postpartum hemorrhage due to hypotonia or uterine atony, at the General Teaching Provincial Hospital of Riobamba from October 2015 to September 2016. Methodology: The effectiveness of the use of the intrauterine compression balloon after the failure of pharmacological management was analyzed and statistical evaluation was applied to determine the efficacy of this method for the management of this pathology. Results: It was placed in 23 patients who presented postpartum hemorrhage due to hypotonia or uterine atony, and it had an effectiveness of 94.4% after a vaginal delivery and 80% after a cesarean section. Reaffirming that it is an excellent option in the management of this type of complications. Conclusions: Postpartum hemorrhage is the second cause of maternal death nationwide, technical and timely action will help reduce maternal morbidity and mortality that this pathology can present; the use of the intrauterine hydrostatic compression balloon is an excellent alternative prior to the surgical management of this pathology. Keywords: postpartum hemorrhage, uterine bleeding, uterine tamponade with balloon. RESUMEN Introducción: La hemorragia posparto es la pérdida sanguínea mayor de 500 mL luego de un parto normal o más de 1000 mL luego de una cesárea, o cualquier sangrado posparto independientemente de la cantidad que cause inestabilidad hemodinámica. El riego sanguíneo uterino en un embarazo a término es de aproximadamente 500 a 700 mL/min por tal motivo, una paciente que presente esta complicación, en pocos minutos puede quedar exangüe y comprometer si vida. Objetivo: Determinar la eficacia del balón de compresión intrauterino en el manejo de la hemorragia posparto por hipotonía o atonía uterina, en el Hospital Provincial General Docente de Riobamba de Octubre del 2015 a septiembre del 2016. Metodología: Se analizó la efectividad del uso del balón de compresión intrauterina luego del fracaso del manejo farmacológico y se aplicó la evaluación estadística para determinar la eficacia de este método para el manejo de esta patología. Resultados: Se colocó en 23 pacientes que presentaron hemorragia posparto por hipotonía o atonía uterina, y se tuvo una efectividad del 94.4 por ciento luego de un parto vaginal y del 80% luego de una cesárea. Reafirmando que es una excelente opción en el manejo de este tipo de complicaciones. Conclusiones: La hemorragia posparto es la segunda causa de muerte materna a nivel nacional, el accionar técnico y oportuno ayudará a disminuir la morbimortalidad materna que puede presentar esta patología; la utilización del balón de compresión hidrostático intrauterino es una excelente alternativa previo al manejo quirúrgico de esta patología. Palabras clave: hemorragia posparto, hemorragia uterina, taponamiento uterino con balón.

2016 ◽  
Vol 19 (3) ◽  
pp. A176 ◽  
Author(s):  
K Pacocha ◽  
I Pieniazek ◽  
M Sobkowski ◽  
Z Celewicz ◽  
J Kalinka ◽  
...  

Author(s):  
Yaneth Gil-Rojas ◽  
Pieralessandro Lasalvia ◽  
Fabián Hernández ◽  
Camilo Castañeda-Cardona ◽  
Diego Rosselli

Objective To assess the cost-effectiveness of carbetocin versus oxytocin for prevention of postpartum hemorrhage (PPH) due to uterine atony after vaginal delivery/cesarean section in women with risk factors for bleeding. Methods A decision tree was developed for vaginal delivery and another one for cesarean, in which a sequential analysis of the results was obtained with the use of carbetocin and oxytocin for prevention of PPH and related consequences. A third-party payer perspective was used; only direct medical costs were considered. Incremental costs and effectiveness in terms of quality-adjusted life years (QALYs) were evaluated for a one-year time horizon. The costs were expressed in 2016 Colombian pesos (1 USD = 3,051 Col$). Results In the vaginal delivery model, the average cost of care for a patient receiving prophylaxis with uterotonic agents was Col$ 347,750 with carbetocin and Col$ 262,491 with oxytocin, while the QALYs were 0.9980 and 0.9979, respectively. The incremental cost-effectiveness ratio is above the cost-effectiveness threshold adopted by Colombia. In the model developed for cesarean section, the average cost of a patient receiving prophylaxis with uterotonics was Col$ 461,750 with carbetocin, and Col$ 481,866 with oxytocin, and the QALYs were 0.9959 and 0.9926, respectively. Carbetocin has lower cost and is more effective, with a saving of Col$ 94,887 per avoided hemorrhagic event. Conclusion In case of elective cesarean delivery, carbetocin is a dominant alternative in the prevention of PPH compared with oxytocin; however, it presents higher costs than oxytocin, with similar effectiveness, in cases of vaginal delivery.


2020 ◽  
Vol 24 (2) ◽  
Author(s):  
DRAKHSHAN NAUMAN ◽  
NADIA SAIF ◽  
UZMA SIDDIQUE ◽  
NOSHEEN NAVEED ◽  
UZMA SIDDIQUE

Objective:  To assess the efficacy of the Hayman suture technique in the management of intraoperative atonic postpartum hemorrhage thus reducing maternal morbidity and mortality. Study Design:  Simple Descriptive study. Materials and Method:  A simple descriptive observational study was conducted at Farooq Hospital and AIT, Lahore. The study included all patients with intraoperative atonic PPH after elective and emergency caesarean sections, during the study period, in whom medical management of PPH failed and Hayman suture was applied. Results:  Hayman suture was 97.5% successful in controlling primary PPH due to intraoperative uterine atony. It failed in only one patient (2.5%) and that patient needed a hysterectomy. Conclusion:  Hayman suture is an effective and quick technique in controlling primary PPH due to intraoperative uterine atony. It is an effective surgical technique after failure of conservative medical management. It is easy to apply and can be applied by Postgraduate trainees and registrar in emergency as lifesaving procedure.


2018 ◽  
Vol 8 (6) ◽  
pp. 178-183
Author(s):  
Dinh Nguyen Gia ◽  
Thanh Cao Ngoc

Background: Postpartum hemorrhage (PPH) remains a significant contributor to maternal morbility and mortality and accounts for 31% of maternal death in Vietnam. The most common cause of PPH is uterine atony. Recently, uterine tamponade using intrauterine condom appears to be an effective tool in the management of intractable PPH. Objectives: To evaluate the success of condom as a tamponade to arrest intractable PPH due to uterine atony in patients not responding to medical management. Materials and Methods: The study was designed as a cross-sectional and descriptive, included 32 patients who underwent condom balloon tamponade at Kontum Provincial Hospital from 1/2012 to 8/2016. Results: 32 women (mean age 25.71 ± 6.45 years range, 16 - 39) underwent condom balloon tamponade for PPH controls. 29 patients (90.62%) successfully responded the tamponade therapy by the use of condom catheter. Three patients (9.37%) required hysterectomy. Conclusions: Condom catheter balloon effectively controls the intractable PPH due to uterine atony. Key words: PPH (Pospartum hemorrhage), Tamponade, Condom catheter balloon, Uterine atony


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.


2009 ◽  
Vol 107 ◽  
pp. S193-S193
Author(s):  
X. Gong ◽  
L. Ma ◽  
X. Bian ◽  
J. Liu ◽  
J. Gao

SCIENTIARVM ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 39-42
Author(s):  
José M. Rojas Durand ◽  
◽  
Gladys E. Nuñez Zevallos ◽  
Mercedes H. Nuñez Zevallos ◽  
◽  
...  

La presente investigación tiene como objetivo determinar el riesgo de mortalidad de pacientes de la población arequipeña que acudió Hospital Nacional Carlos Alberto Seguin Escobedo (HNCASE) usando el score GRACE y hallar la relación del sexo con el resultado de obtener un riesgo alto del score. El estudio fue diseñado con carácter descriptivo correlacional y transversal, para la recolección de datos se acudió a los departamentos de estadística y cardiología del HNCASE, se elaboró una base de datos en el programa Excel 2019, utilizando como herramienta el score GRACE, un score validado al nivel internacional, se calculó el riesgo de muerte de los pacientes con SCA. Con el mismo programa, se elaboraron tablas de frecuencias y promedios para elaborar el informe y, para relacionar el riesgo alto del score GRACE con el sexo de los pacientes, se usó la prueba estadística del Chi Cuadrado. No se consideró a la angina estable ni a la de Prinzmetal en este estudio. Se registraron 234 casos de SCA entre Infartos y Angina Inestable. Varones 76.5%, Mujeres 23.5%. La edad media de mujeres fue de 73 y de varones 67. Los casos más presentados fueron de Infarto agudo de miocardio sin elevación del segmento ST (IAMNSTE) 154 (67%) seguido de Angina inestable 44 casos (18%) e Infarto agudo de miocardio con elevación del segmento ST (IAMSTE) 36 casos (15%). La mayoría de casos tuvieron un score GRACE con riesgo Alto (59% en todos los casos de SCA y 66% en los casos de Infarto Agudo de Miocardio) No hubo diferencia en el número de atenciones realizadas de casos de SCA antes de la pandemia por SARSCOV2 vs. durante la pandemia. Los fallecidos fueron 22 (9.4%). En este estudio se encontró una relación significativa entre el sexo y la probabilidad de obtener un score GRACE con riesgo ALTO de mortalidad, estando en la población arequipeña las mujeres más propensas a obtener un puntaje ALTO a diferencia de los varones. Se concluye que muchos de los resultados obtenidos se parecen a los que se encontraron en estudios hechos en España y Cuba. Se recomienda utilizar un score validado al nivel internacional para determinar el riesgo de mortalidad y así dar un tratamiento ideal, pero no se debe dejar de lado el criterio médico. Palabras clave: Síndrome coronario agudo, Población Arequipeña, score GRACE, riesgo de mortalidad.


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