birth / abstract

SUMMARY

Purpose: To evaluate the effectiveness of the Bakri balloon in the treatment of postpartum hemorrhage. Postpartum hemorrhage is the most common cause of postpartum maternal death worldwide. It is a potentially fatal complication in both vaginal and cesarean deliveries. Both conservative and invasive surgical interventions are required in postpartum hemorrhage cases in which hemorrhage control fails with medical treatments. In the final stage, hysterectomy may be necessary. Invasive surgical interventions are associated with comorbidity and the potential to affect future fertility. Intrauterine balloon tamponade systems such as Bakri balloon are among the more conservative interventions.

Material and Methods: In this retrospective observational study, the records of 25 patients who were treated for postpartum hemorrhage in Turgut Özal University Hospital Gynecology and Obstetrics clinic between January 2009 and August 2014 were reviewed. The frequency of the interventions and the effect of the interventions in terms of stopping the bleeding without the need for hysterectomy were investigated.

Results: Bleeding was stopped in all 12 patients who underwent Bakri balloon application without the need for hysterectomy. In contrast, 77.8% of 9 women who underwent arterial ligation required hysterectomy, while 31.3% of 16 women who did not undergo arterial ligation required hysterectomy. Concomitant use of more than one surgical technique is also significantly associated with a higher risk of hysterectomy compared to a single surgical procedure.

Conclusion: Bakri balloon application is a very effective method for stopping postpartum bleeding without the need for hysterectomy.

ABSTRACT

Objective: To evaluate the effectiveness of Bakri Balloon in post-partum haemorrhage treatment. Post-partum haemorrhage is the most common cause of maternal death in the world. It is potentially fatal complication of both vaginal and caesarean deliveries. In situations where medical interventions are unsuccessful in achieving haemostasis in cases of post-partum haemorrhage, either conservative or invasive surgical therapies are needed. Ultimately hysterectomy may be required. Invasive surgical interventions are associated with co-morbidities and potential implications for future fertility. Among the more conservative interventions are intrauterine balloon tamponade such as the Bakri balloon.

Material and Methods: In this retrospective, observational study, records of 25 patients who were treated for post-partum haemorrhage in the Obstetrics and Gynecology Clinic of Turgut Ozal University Hospital, between January 2009 and August 2014 were examined. Frequency and efficacy of interventions were investigated in terms of haemostasis achievement without recourse to hysterectomy.

Results: In 12 women who underwent Bakri balloon placement, haemostasis was achieved in all patients without subsequent hysterectomy. By contrast, of 9 women who underwent arterial ligation, 77.8% required hysterectomy as opposed to 31.3% of the 16 women who did not undergo arterial ligation. Use of combinations of surgical techniques was also significantly associated with higher risk of hysterectomy when compared to single techniques.

Conclusion: Use of Bakri balloon is a highly effective method in achieving haemostasis in post-partum haemorrhage without necessity of hysterectomy.

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