Efficacy of Balloon Tamponade in the Management Primary Postpartum Haemmorhage

Abstract

ABSTRACT

Background: Postpartum Haemmorhage is the leading cause of maternal death all over the world. It remains a serious complication of childbirth in developed and developing countries.

Objective: To evaluate the success of uterine balloon tamponade in those patients suffering from postpartum Haemmorhage where medical treatment has failed.

Materials and Methods: This study was conducted in Gynae Department of Khyber Teaching Hospital, Peshawar from 1st January 2022 to 31st December 2022.Cross sectional is the type of study design and no probability sampling is the type of sampling method. All patients with primary postpartum Haemmorhage, in 15-45 years age range, who delivered vaginally after a full term pregnancy, were included. Those having history of caesarean section, uterine anomalies, preterm labor, morbidly adherent placentas, placental abruptions, placenta previas and retained products were excluded. All the patients where the cause of PPH was uterine atony were first managed with pharmacological treatment, which if failed then uterine balloon tamponade was inserted. Tamponade was removed after 24-48 hours. Failure in cessation of bleeding was followed by surgical management in the form of B lynch suture or hysterectomy. Data was collected in a predesigned Proforma.

Results: The mean age was 26.02+4.42 years.9.72% women had past history of PPH. Majority of our study population was grand Multigravidas(61.57%) and the most prevalent age group was 26-35 years age group.87% women responded to medical treatment and UBT was applied in the rest. The UBT success rate was 89.2% whereas it failed in 10.8% women where laprotomies were conducted. The higher response rate was noticed in grand Multigravidas (50%) and in 26-35 years age group (46%).It failed in three patients who had no history of PPH and was successful in those with coagulopathies.

Conclusion: The response rate to uterine balloon tamponade is higher in patients with postpartum Haemmorhage due to uterine atony. Before embarking on surgical procedures with many possible complications, uterine balloon tamponade should be used