TO EVALUATE THE EFFECTIVENESS OF CONDOM BALLOON CATHETER IN TREATING INTRACTABLE POSTPARTUM HEMORRHAGE AT KONTUM PROVINCIAL HOSPITAL

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 11 (1) ◽  
pp. 34-38
Author(s):  
Zareena Begam ◽  
Neelum Zahir ◽  
Farhadia Sadaf

Background: Primary postpartum hemorrhage has a significant effect on maternal morbidity and mortality. Proper treatment andin time management of the patient have showed to decrease this morbidity and mortality a lot.Objective: The objective of our study is to find out the efficacy of balloon tamponade in the management of primarypostpartum hemorrhage.Material and Method: This study was conducted in Saidu group of teaching hospital, swat from 1st august 2018 to 31st July2019. All the patient with Primary postpartum hemorrhage were included in the study. All patients were first managed bymedical therapy and when the medial therapy failed then balloon catheter tamponade were introduced and patients werenoticed for stoppage of bleeding within few minutes.Result: Mean age was 27.04±5.42 years. 72 patients failed from medical therapy which was managed by condom tamponade.The response rate of condom tamponade in these 72 patient was 69 (95.83%) while 3 (4.17%) did not respond. There was nosignificant effect of age, gravida on the response rate of Balloon tamponade.Conclusion: The response rate to Balloon Catheter tamponade is high in patient with Primary postpartum hemorrhage due touterine atony. It should be tried before preceding to other Surgical management like Be-lynch, uterine artery ligation orhysterectomy in cases of medical therapy failure.Key Words: primary postpartum hemorrhage, Medical Management, Condom catheter, Response rate.


Author(s):  
Renu Jain

Background: In low-resource countries, Postpartum Hemorrhage (PPH) is the leading cause of maternal mortality. The intrauterine balloon tamponade was recently incorporated into the strategy to manage uterine atony. There are many types of tamponades. Among them, the condom catheter seems to be an efficient and economic intervention for the treatment of PPH in low-resource countries. The aim of present study was to evaluate the effectiveness of the condom catheter balloon in treating postpartum hemorrhage refractory to medical treatment.Methods: The retrospective analysis of 22 cases of PPH, treated with a condom catheter as a conservative therapeutic option, was done in department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.Results: The condom catheter was successful in controlling PPH in 90.9% cases. It was effective in 94.44% women with uterine atony, who did not respond to uterotonic drugs. It was also effective in one case of placental implantation site bleeding and two cases of deranged coagulation function. In 2 cases it failed to control PPH and peripartum hysterectomy was done. The volume of saline solution used to fill the balloon was from 150 -350 ml and the time for which the balloon remained inflated was 36-48 hours. No case of febrile morbidity and wound sepsis was noted. There was no maternal death.Conclusions: Its ease of use and high effectiveness make condom catheter a useful approach for the conservative management of PPH. This device reduces bleeding, shortens the hospital stay and avoids the need for more aggressive procedures.


2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Masato Kinugasa ◽  
Hanako Tamai ◽  
Mayu Miyake ◽  
Takashi Shimizu

While uterine balloon tamponade is an effective modality for control of postpartum hemorrhage, the reported success rates have ranged from the level of 60% to the level of 80%. In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort. We developed a modified tamponade method and applied it to two cases of refractory postpartum hemorrhage after vaginal delivery. The first case was accompanied by uterine myoma and low-lying placenta. After an induced delivery, the patient had excessive hemorrhage due to uterine atony. Despite oxytocin infusion and bimanual uterine compression, the total blood loss was estimated at 2,800 mL or more. The second case was diagnosed as placental abruption complicated by fetal death and severe disseminated intravascular coagulation, subsequently. A profuse hemorrhage continued despite administration of uterotonics, fluid, and blood transfusion. The total blood loss was more than 5,000 mL. In each case, an intrauterine balloon catheter was wrapped in gauze impregnated with tranexamic acid, inserted into the uterus, and inflated sufficiently with sterile water. In this way, mechanical compression by a balloon and a topical antifibrinolytic agent were combined together. This method brought complete hemostasis and no further treatments were needed. Both the women left hospital in stable condition.


Author(s):  
Sumitra Yadav ◽  
Anjali Malhotra

Background: PPH is responsible for quarter of maternal deaths occurring worldwide and its incidence is increasing in developed world. According to Confidential Enquiries into Maternal and Child Health (CEMACH) report obstetric hemorrhage occurs in around3.7 per 1000 births. The objective of the study is that it was a prospective randomized comparative study of misoprostol and balloon tamponade via condom catheter to prevent postpartum hemorrhage in normal delivered patients at MYH.Methods: A sample size of 200 normal delivered patients between age group 18 and 45 years is chosen with excessive bleeding after third stage of labour and after administration of oxytocics. These 200 patients are divided into two groups: First group receiving Misoprostol and applying condom catheter in other group. Both groups are evaluated for PPH.Results: It was found that CG balloon condom catheter was a much better and more effective alternative in controlling PPH than Misoprostol as the failure rate with CG balloon condom catheter were  much less than that  with misoprostol. Due to its cost effectiveness and being easily available at primary health center and due to absence of any drug reactions and easy technique of formation makes it a better modality in controlling PPH even at PHC.Conclusions: Patients with condom catheter in situ must show better result than patients receiving misoprostol.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Marzieh Ghasemi ◽  
Narjes Noori ◽  
Ghazaleh Parnian ◽  
Erfan Ayubi ◽  
Farangis Narouei

Background: Recognizing the factors affecting maternal death can lead to the adoption of strategies to prevent similar deaths. Objectives: This study was performed to investigate the prevalence and causes of pregnant mothers' death in the population covered by Zahedan University of Medical Sciences. Methods: In this retrospective, descriptive, cross-sectional study, the files of 126 pregnant mothers who died during 2013 - 2017 were evaluated. Demographic and obstetrics information and variables related to maternal mortality, such as maternal mortality ratio (MMR), the cause of mother’s death, the time of mother’s death, and place of death, were evaluated in general and separately in each city (i.e., Zahedan, Khash, Saravan, and Chabahar) based on descriptive statistics and according to the nature of the variables. Results: Maternal mortality ratio in Zahedan was 174.96 per 100,000 case, in Khash 190.56 per 100,000 cases, in Saravan 371.87 per 100,000 cases, and in Chabahar 384.03 per 100,000 cases. Bleeding was the most common cause of death (42.53%), 61.9% of pregnant women were living in rural areas, 80.2% died in the third trimester of pregnancy, and 42.9% died in first 24 hours after delivery. The most common underlying disease was hypertension, 70.6% of mothers died in hospitals, and 47.6% were illiterate. The most common cause of maternal death in Zahedan was cardiac disease, in Khash it was hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, eclampsia, and preeclampsia, and in Saravan and Chabahar the leading cause was bleeding. Conclusions: Maternal mortality ratio was high in Sistan and Baluchestan. The investigation of the causes of maternal deaths showed that some of these deaths are avoidable. It is also necessary to improve midwifery emergencies management with intensive monthly courses to increase team capabilities for making the best use of golden time measures.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245988
Author(s):  
Holly A. Anger ◽  
Jill Durocher ◽  
Rasha Dabash ◽  
Nevine Hassanein ◽  
Sam Ononge ◽  
...  

Objective We aimed to determine the risk of postpartum infection and increased pain associated with use of condom-catheter uterine balloon tamponade (UBT) among women diagnosed with postpartum hemorrhage (PPH) in three low- and middle-income countries (LMICs). We also sought women’s opinions on their overall experience of PPH care. Methods This prospective cohort study compared women diagnosed with PPH who received and did not receive UBT (UBT group and no-UBT group, respectively) at 18 secondary level hospitals in Uganda, Egypt, and Senegal that participated in a stepped wedge, cluster-randomized trial assessing UBT introduction. Key outcomes were reported pain (on a scale 0–10) in the immediate postpartum period and receipt of antibiotics within four weeks postpartum (a proxy for postpartum infection). Outcomes related to satisfaction with care and aspects women liked most and least about PPH care were also reported. Results Among women diagnosed with PPH, 58 were in the UBT group and 2188 in the no-UBT group. Self-reported, post-discharge antibiotic use within four weeks postpartum was similar in the UBT (3/58, 5.6%) and no-UBT groups (100/2188, 4.6%, risk ratio = 1.22, 95% confidence interval [CI]: 0.45–3.35). A high postpartum pain score of 8–10 was more common among women in the UBT group (17/46, 37.0%) than in the no-UBT group (360/1805, 19.9%, relative risk ratio = 3.64, 95% CI:1.30–10.16). Most women were satisfied with their care (1935/2325, 83.2%). When asked what they liked least about care, the most common responses were that medications (580/1511, 38.4%) and medical supplies (503/1511, 33.3%) were unavailable. Conclusion UBT did not increase the risk of postpartum infection among this population. Women who receive UBT may experience higher degrees of pain compared to women who do not receive UBT. Women’s satisfaction with their care and stockouts of medications and other supplies deserve greater attention when introducing new technologies like UBT.


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