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

Shashikala B. Patil, Indumathi H. K., Sarojini ., Savitha C.


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.



Postpartum Hemorrhage, Bakri balloon, Uterine balloon tamponade

Full Text:



WHO recommendations on prevention and treatment of postpartum haemorrhage. Available at: Accessed on 20 My 2021.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-33.

Li XF, Fortney JA, Kotelchuck M, Glover LH. The postpartum period: the key to maternal mortality. Int J Gynaecol Obstet. 1996;54(1):1-10.

Tindell K, Garfinkel R, Abu-Haydar E. Uterine balloon tamponade for the treatment of postpartum haemorrhage in resource-poor settings: a systematic review. BJOG. 2013;120:5-10.

Steven GG, Jennifer RN. Text book of obstetrics normal and abnormal pregnancies. 7th edn. Netherlands: Elsevier publisher; 2008.

Aibar L, Aguilar MT, Puertas A, Valverde M. Bakri balloon for the management of postpartum hemorrhage. Acta Obstet Gynecol Scand 2013;92: 46-9.

Alouini S, Bedouet L, Ramos A, Ceccaldi C, Evrard ML, Khadre K. Bakri balloon tamponade for severe post-partum haemorrhage: efficiency and fertility outcomes. J Gynecol Obstet Biol Reprod. 2014;45: 52-9.

Vitthala S, Tsoumpou I, Anjum ZK, Aziz NA. Use of Bakri balloon in post-partum haemorrhage: a series of 15 cases. Aust N Z J Obstet Gynaecol. 2009;49:191-4.

Suarez S, Conde-Agudelo A, Borovac-Pinheiro A. Uterine balloon tamponade for the treatment of postpartum hemorrhage: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;222:e1-52.

Sunjaya AP, Dewi AK. Total uterine inversion post partum: case report and management strategies. J Family Reprod Health. 2018;12(4):223-5.

Yadav S, Malhotra A. Novel use of balloon tamponade saves a patient with uterine inversion in severe shock. Int J Reprod Contracept Obstet Gynecol. 2017;6:5638-41.

Vivanti AJ, Furet E, Nizard J. Successful use of a Bakri Tamponade Balloon in the treatment of puerperal uterine inversion during caesarean section. J Gynecol Obstet Hum Reprod. 2017;46(1):101-2.

Jelks A, Berletti M, Hamlett L, Hugin M. Nonpneumatic antishock garment combined with bakri balloon as a nonoperative "uterine sandwich" for temporization of massive postpartum hemorrhage from disseminated intravascular coagulation. Case Rep Obstet Gynecol. 2015;2015:124157.

Sheldon WR, Blum J, Vogel JP. Postpartum haemorrhage management, risks, and maternal outcomes: findings from the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG. 2014;121(1):5-14.