Intrauterine Bakri Balloon Tamponade In The Management Of Postpartum Hemorrhage

Objective:The aim of this study was to evaluate the effectiveness of the Bakri balloon tamponade in treating postpartum hemorrhage refractory to medical treatment and to investigate the best indications of Bakri balloon.Methods:This retrospective study included226women with PPH, who were treated with surgical treatment but refractory to medical treatment. According to the surgical approach, they were divided into five groups:(1) Bakri balloon group,(2) B-Lynch compression sutures group,(3) Uterine artery ligation group,(4) Interventional radiology group,(5) Hysterectomy group. We analyzed the intraoperative, postoperative situations and the treatment results of all women.Results:(1) There were15,475deliveries in our hospital in the last four years, including1,387cases of PPH, the total incidence rate was8.96%.(2) The efficacy of Bakri balloon tamponade management of PPH which caused by different causes was no significant difference (P>0.05). The effective of Bakri balloon tamponade is better than the uterine artery ligation and B-Lynch suture for which PPH was due to Placenta previa or placenta accreta (P<0.01). It applies to the postpartum hemorrhage which caused by Placenta previa or placenta accreta.(3) The effective of Bakri balloon tamponade is better than the uterine artery ligation and arterial embolization (P<0.05).(4) The factors including the mean operation time, estimated blood loss, transfusions,puerperal morbidity and transferred to ICU have significant differences between between groups which had Bakri balloon and which had Hysterectomy (P<0.05).(5) The effective of which had internal iliac artery balloons placed preoperatively was significant difference compare with the group which did not (P<0.05).The mean estimated blood loss and transfusions were no statistical difference between these two groups (P>0.05).Conclusion:(1) Most PPH can be successfully stoped the bleeding after timely massage the uterus and medication to strengthen contractions.(2) Bakri balloon tamponade, B-Lynch compression suture, Uterine artery ligation and arterial embolization are effective methods of treatment of PPH. These methods can be used alone or in combination.(3) Bakri balloon tamponade can be used in PPH caused by various reasons. Bakri balloon can be the most preferred method of treatment of PPH which caused by Placenta previa or placenta accreta.(4) And it is highly effective, simple operating and lowly invasive traditional treatment, and it not only can prevent hysterectomy, but also shorten the hospital stay and reduce the financial burden of patients.