Solution to Technical Difficulties of Uterine Balloon Tamponade Placement in Primary PPH Management: A Retrospective Case Series
Noreen Nasim, Shazia Majid Khan, Ayesha Zafar, Sara Yousuf, Moeen Akhtar Malik
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ABSTRACT
Objective: The aim of this study was to devise and enforce a simple yet effective method of condom placement for IUBT
while dealing with all the technical difficulties in a poor resource setup to control primary PPH to save life of mother.
Methodology: It is a retrospective case series study that is based on the hospital data obtained from Gynecology and
Obstetrics Department of Sheikh Zayed Hospital, Rahim Yar Khan for a period of 8 months (July 2019 to Feb 2020) .
Patients with persistent primary PPH after medical management who were given intra-uterine balloon tamponade (IUBT)
were included in this study after evaluation for possible risk factors of PPH. Sample size was kept 30 with power of test
at 80% and level of significance at 5%. Statistical assessment of the variables was done and the data was analyzed with
SPSS v.21.
Results: The 30 female patients, included in this study, had mean age of 30.3±6.06 years ranging from 17 to 39 years.
Condom IUBT was successfully placed in 28(93.3%) patients by using 4 ring forceps applied on cervix and tied together
with a gauze to keep the balloon in utero in order to control bleeding of PPH while in 2(6.66%) patients; it was
unsuccessful due to inexperience of the operating staff. Out of these 28 patients with successful IUBT placement,
condom based intra-uterine balloon tamponade was successful in controlling bleeding of PPH in 26(92.86%) patients
while in 2(7.14%) patients, bleeding was not controlled and they underwent surgical interventions.
Conclusion: Condom based Intra-uterine balloon tamponade is a simple yet effective method to control bleeding in
primary postpartum hemorrhage but needs positive re-enforcement in the form of awareness/training sessions for the
healthcare staff.
Keywords: Catheter, Post-Partum Morbidity, Condom, Intra-Uterine Balloon Tamponade, Hemorrhage, Hysterectomy