Abstract

Background: Obstetric haemorrhage remains the most important cause of maternal mortality worldwide accounting for 25% of maternal deaths annually. The aim of the study was to evaluate efficacy of a foleys balloon catheter assembly for uterine tamponade in the management of non-traumatic postpartum haemorrhage (PPH).

Methods: It is a prospective interventional study done in a tertiary care hospital in Tamilnadu state, Vellore district, Government Vellore Medical college Adukkamparai, India.. 145 women with intractable PPH unresponsive to medical management are managed by intrauterine Foleys balloon tamponade using a foley-catheter assembly prior to surgical intervention.

Results: The Foleys balloon catheter tamponade successfully controlled haemorrhage in131 out of 145 patients. It is observed that among the 12   failed cases, hysterectomy was required. Further the cases were managed by doing bilateral internal iliac artery ligation. Among the failed cases there was a one maternal death due to sepsis and multi-organ dysfunction syndrome(MODS). It is also observed that in all  cases where the balloon was successful, it was removed around 24 hours later and no further bleeding or complication was noted.

Conclusions: Placement of a Foleys catheter balloon tamponade can successfully treat non-traumatic PPH refractory to medical management. It is simple, inexpensive, easily available and in those with successful placement no procedure related morbidity was observed. The potential for this method is it can be used  inexperienced operators in areas with limited resources and makes it a useful tool in management of PPH.

Keywords: Postpartum haemorrhage, Condom catheter balloon, Non-traumatic.