Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series

In this study, a treatment method was assessed for the prevention and treatment of postpartum bleeding after combined surgery in patients having late pregnancy with the complication of acute Stanford type A aortic dissection. The clinical records of ten patients receiving treatment at the Second Xiangya Hospital of Central South University between March 2012 and March 2021 were retrospectively analysed. All patients were diagnosed with acute Stanford type A aortic dissection according to computed tomography angiography of the thoracic and abdominal aorta. Aortic valve function was assessed using two-dimensional echocardiography. All patients experienced uterine-incision delivery under systemic anaesthesia. During the operation, intrauterine Bakri balloon tamponade and cervical cerclage were performed. Postpartum bleeding was effectively controlled for all patients. The extracorporeal circulation time was 230–295 min, the postpartum 24 h bleeding volume was 500–870 mL, the volume of physiological saline injected into the balloon was 290–515 mL, and the intrauterine balloon compression time was 28–51 h. No postpartum bleeding occurred. A 42-days follow-up showed no late postpartum bleeding, poor uterine incision healing, or puerperal infection, and no uterine removal was performed. Intrauterine Bakri balloon tamponade plus cervical cerclage can effectively prevent intra- and postoperative postpartum bleeding in pregnant patients with aortic dissection.

A study of uterine balloon tamponade for the management postpartum haemorrhage using Bakri balloon

Background: PPH is the most common cause of maternal morbidity and mortality around the world. Incidence of PPH is 2-4% following vaginal delivery and 6% following cesarean delivery in India. Uterine atony is the most common cause of PPH. Treatment of PPH involves medical treatment and surgical management. In between medical and surgical management of PPH comes uterine balloon tamponade which is simple, less invasive and can be managed with minimal training.Methods: A retrospective cohort study was done for 2 years at Vanivilas hospital, Bangalore medical college and research centre, Bangalore, Karnataka. Cases of atonic PPH managed using Bakri balloon were included in the study. The objective of the study was to study the effectiveness of uterine balloon tamponade using Bakri balloon in the management of atonic PPH and to study the maternal outcome.Results: In this study total of 50 cases were included. Women were in the age group of 18 to 33years. Regarding obstetric history, 22 (44%) were primigravida and 28 (56%) was multigravida. Among these 50 cases 8 (16%) women had undergone caesarean delivery and 42(84%) had vaginal delivery. All women received blood transfusion, 17 (34%) received blood and blood components (like PRBC, FFP AND platelets) and 33 (66%) cases received only PRBC transfusion. In these 50 cases, 32 (64%) required ICU admission for monitoring, remaining 18 (36%) were monitored in the labor-room. Bakri balloon was effective in 49 cases among 50. Success rate was 98%.Conclusions: Intrauterine balloon tamponade using Bakri balloon is effective for control of atonic PPH in majority of cases.

Use of bakri balloon catheter and pedicled omental flap in combination for pelvic reconstruction after total pelvic exenteration

Our case was a middle-aged woman with advanced cervical cancer that underwent pelvic exenteration (PE) and then pelvic reconstruction (PR) with omental flap and bakri balloon placement.

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

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.

Research on Application of Bakri Balloon Tamponade in Treatment of 169 Cases of Postpartum Hemorrhage

Background: To acquire a better understanding of application effect, advantages and disadvantages of Bakri balloon tamponade in treatment of postpartum hemorrhage, and explore the appropriate pathological occasion and optimal timing for placing Bakri balloon.Methods: A retrospective study which used Bakri balloon for postpartum hemorrhage was conducted from January 1, 2016 to December 31, 2019 in our hospital .Results: There were 169 patients who treated with Bakri balloon tamponade, no detachment occurred after Bakri balloon cervical forceps clipped with toothless oval forceps. There were 148 cases of successful balloon tamponade hemostasis, accounting for 87.6%，and 21 failure cases, accounting for 12.4%. The failure rate of balloon tamponade hemostasis significantly increased in the case of over 1500ml bleeding. In the failure group, placental adhesion and accreta accounted for 57.1% (12/21), and placental implantation was found an important factor causing balloon tamponade hemostasis failure.Conclusion: Cervical forceps clipped with toothless oval forceps can effectively prevent the failure of hemostasis due to balloon prolapse. When postpartum hemorrhage reaches 1500ml and/or placenta accreta is carried out, failure rate of balloon tamponade hemostasis will increase significantly. Nevertheless, it could be used as a temporary measure for less hemorrhage volume and more time toward further treatment.