297 - Bakri balloon tamponade and uterine packing with gauze in post partum hemorrhage management: any differences?
297 - Bakri balloon tamponade and uterine packing with gauze in post partum hemorrhage management: any differences?
Luisa Patanè, Giorgia Cavalli, Valentina Mandelli, Nicola Strobelt, Luigi Frigerio, Serena Pirola, Maria Giovanna Piccoli
American Journal of Obstetrics & Gynecology (Vol.210, Issue 1)
OBJECTIVE: To compare the safety and ef fi cacy of Bakri balloon tamponade (BBT) and uterine gauze packing (UGP) in case of severe post partum hemorrhage (PPH) refractory to medical therapy.
STUDY DESIGN: We retrospectively reviewed and analyzed all the datacharts of severe PPH (blood loss > 1000 mL) occurred between January 2011 and May 2013 in our institution, in which BBT or UPG were used as second line therapy after failure of medical treatment.
Multiple gestations were excluded from the analysis.
Procedure was considered successfull when no additional therapies for hemorrhage control were needed. In case of procedure failure the successive treatments included radiologically guided uterine artery embolization (UAE) and/or surgical procedures (uterine compression sutures, artery ligation and hysterectomy). We compared BBT and UGP in term of safety and ef fi cacy in controlling severe PPH.
P < 0.05 was considered statistically signi fi cant.
RESULTS: In the study period 61 uterine tamponades were performed: 32 with Bakri balloon (group A) and 29 with uterine gauze (group B). The two groups were similar according to maternal characteristics, delivery mode, mean blood loss, need for transfusions, rate of endometritis and days of recovery. BBT alone was successfull in 26/32 cases (81%), in 6 cases (19%) additional UAE was required. No hysterectomies were performed in the Bakri group. UGP alone was effective in 20/29 cases (68%), 8 patients needed an UAE and 2 cases required an hysterectomy. The effectiveness of the two methods was comparable (26/32 vs 20/29; p< 0.2).
CONCLUSION: BBT and UPG are both safe and effective methods to control severe PPH after failure of traditional medical therapy.