DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20182413

Uterine tamponade using condom catheter balloon in the management of non-traumatic postpartum hemorrhage

Renu Jain

Abstract


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.


Keywords


Maternal mortality, Postpartum hemorrhage (PPH), Peripartum hysterectomy

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References


WHO. WHO recommendations for the prevention and treatment of post partum haemorrhage. Geneva: WHO; 2012. Available at http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241548502/en/

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23rd edition. New York: McGraw Hill Medical; 2010:757-798.

Bhide A, Arulkumaran S, Damania KR, Daftary SN. Arias’ Practical guide to high risk pregnancy and delivery. 3th edition. New Delhi: Elsevier;2008:348- 351.

Royal College of Obstetricians and Gynaecologists. Prevention and management of post partum haemorrhage. Green-top Guideline No. 52. London: RCOG; 2009.

FIGO. FIGO Guidelines: Prevention and treatment of post partum hemorrhage in low resource settings. Int J Gynaecol Obstet. 2012;117:108-18.

Georgiou C. Current use of Balloon tamponade technology in the management of postpartum haemorrhage. Hypertens Res Pregnancy. 2014;2:1-10.

Mishra N, Agrawal S, Gulabani K, Shrivastava C. Use of an Innovative Condom Balloon Tamponade in Postpartum Haemorrhage: A Report. J Obstet Gynaecol India. 2016 Feb;66(1):63-7.

Akhter S, Begum MR, Kabir Z, Rashid M, Laila TR, et al. Use of a condom to control massive postpartum hemorrhage. Medscape General Med. 2003;5 (3):38.

Doumouchtsis SK, Papageorghiou AT, Arulkumaran S. Systematic review of conservative management of postpartum hemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv. 2007;62:540-7.

Dabelea V, Schultze PM, Duffie RS Jr. Intra uterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol. 2007; 24: 359-64.

Airede LR, Nnandi DC. The use of the condom-catheter for the treatment of postpartum hemorrhage. Trop Doct. 2008;38:84-6.

Georgiou C. Balloon tamponade in the management of postpartum haemorrhage: a review. BJOG. 2009;116:748-57.

Tirumuru S, Saba S, Morsi H, Muammar B. Intrauterine balloon tamponade in the management of severe postpartum hemorrhage: A case series from a busy UK district general hospital. Open J Obstet Gynecol. 2013;3:131-6.

Kadioglu BG, Tanriverdi EC, Aksoy AN. Balloon tamponade in the management of post partum hemorrhage: Three years of experience in a single center. Open J Obstet Gynaecol. 2016;6:698-704.

Alkis I, Karaman E, Han A, Ark CH, Buyukkaya B. The fertility sparing management of postpartum hemorrhage: A series of 47 cases of Bakri balloon tamponade. Taiwanese J Obstet Gynecol. 2015;54:232-5.

Tindell K, Garfinkel R, Abu-Haydar E, Ahn R, Burke T, Conn K, Eckardt M. Uterine balloon tamponade for the treatment of postpartum haemorrhage in resource-poor settings: a systematic review. BJOG. 2013;120:5-14.

Ajayi OA, Sant M, Ikhena S, Bako A. Uterine rupture complicating sequential curettage and Bakri balloon tamponade to control secondary PPH. BMJ Case Rep. 2013;2013.

Say L, Chou D, Gemmill A, Tunçalp O, Moller AB, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2:323-33.