Abstract
Background: There are many types of uterine tamponades with uterine drainage port. Among them, the condom catheter seems to be an efficient, easy available and economic intervention for the treatment of PPH in low-resource countries. The aim of this study to evaluated the method, efficacy and outcomes of Atonic PPH with various types of Condom balloon tamponade.
Material & Methods: Our study was a prospective interventional study conducted at a tertiary care centre SMS medical college jaipur, India from January 2017 to October 2017. All patients who delivered vaginally and those who developed non-traumatic postpartum haemorrhage not responding to medical management were included in this study. These 30 cases were divided into 3 groups: Group I- managed by conventional CBT, Group II- managed by CBT with tip cut & Group III- managed by chattisgarh CBT i.e. CG-Balloon. All three groups were compared according to their time comsumption, cost effectiveness, chances of slippage and leakage, deflation, blood loss , success rate, advantages and disadvantages etc.
Results: The age of the patients ranged from 18-40 years, with the mean age group of 20-30 years. PPH occurred mostly in women of 2-4 parity. In antenatal care the 63% of the women reported to have PPH were unbooked cases. Therefore, the fastest and easiest to assemble CBT was CBT with tipcut> CG-Balloon>Conv CBT. Out of 30 cases, 27 cases had successful tamponade and 69% of cases ie 23 cases needed continous oxytocin infusion for less than 12 hours.
Conclusion: We concluded that balloon tamponade method should become a familiar component of existing guidelines for the management of PPH, although not as an isolated form of therapy and modification of conventional CBT should be used as a second line of management in Atonic PPH.
Keywords: Uterine Tamponades, Conventional CBT, CG-Balloon, Atonic PPH.
References
- World Health Organisation (WHO). Maternal mortality in 2000: Estimates developed by WHO,UNICEF,and UNFPA,Geneva:WHO;2004 (Cited on March 25). Available from http://whqlibdoc.who.int/hq/2000/a81531.
- World Health Organisation (WHO). The World Health Report 2005: Make every mother and child count. Geneva, Switzerland: WHO Press;2005. (Cited on March 25). Available from http://www.who.int/whr/2005/en/index. html
- Selo-Ojeme DO (2002) Primary postpartum haemorrhage. J Obstet Gynaecol 22: 463-469.
- Williams ostretrics textbook 24th
- Haeri S, Dildy GA (2012) Maternal mortality from hemorrhage. Semin Perinatol 36: 48-55.
- Bateman BT, Berman MF, Riley LE, Leffert LR (2010) The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries. Anesth Analg 110: 1368-1373.
- Maine D, Rosenfield A, Wallis M. Prevention of maternal death in developing countries. New York, NY:The Center for Population of Family Health; 1999.
- Prendiville WJ, Elbourne D, McDonald S. Active vs expectant management of the third stage of labour (Cochrane Review). In: The Cochrane Library. Issue 3, 2000. Oxford: Update software.
- Vangsgaard K. “B-Lynch-suture” in uterine atony. Ugeshr- Laeger. 2000; 162: 3468.
- B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ. The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol.
- Stanco LM, Schrimmer DB, Paul RH, Mishell DR. Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynaecol. 1993;168: 879-83.
- Abu-Heija AT, Jallad FF. Emergency peripartum hysterectomy at the Princess Badees Teaching Hospital in North Jordan. J Obstet Gynaecol Res. 1999; 25; 193-95.
- Royal College of Obstetricians and Gynaecologists. RCOG Draft Guideline. Prevention and Management of Postpartum Haemorrhage.2008
- Rogers MS, Chang AMZ. Postpartum haemorrhage and other problems of the third stage. In: James DK, Steer PJ, Weiner CP, Gonik B, editors. High Risk Pregnancy: Management Options, 3rd edn. Chapter 77. Philadelphia, PA, USA: Elsevier/Saunders; 2006. pp. 1566–1571.
- Brace V, Kernaghan D, Penney G. Learning from adverse outcomes: major obstetric haemorrhage in Scotland, 2003-05. BJOG 2007;114: 1388–96.
- FIGO guidelines: prevention and treatment of postpartum hemorrhage in low-resource settings. Int J Gynaecol Obstet. 2012;117:108–18.
- Tindell K, Garfinkel R, Abu-Haydar E, Ahn R, Burke T, et al. (2012) Uterine balloon tamponade for the treatment of postpartum haemorrhage in resource-poor settings: a systematic review. BJOG 120: 5-14.
- Akhter S, Begum MR, Kabir Z, Rashid M, Laila TR, Zabeen F. Use of a condom to control massive postpartum haemorrhage. Med Gen Med. 2003;5(3):38.
- Nalini Mishra1 Sumi Agrawal1 Kanchan Gulabani1 Chandrashekhar Shrivastava1 Use of an Innovative Condom Balloon Tamponade in Postpartum Haemorrhage: A ReportThe Journal of Obstetrics and Gynecology of India (January–February 2016) 66(1):63–67.
- Rathore AM, Gupta S, Manaktala U, Gupta S,Dubhey C, Khan AM. Uterine tamponade using condom catheter balloon in the management of Nontraumatic postpartum haemorrhage. J Obstet Gynaecol Res. 2012;38:1162.
Corresponding Author
Dr Megha Agrawal
Assistant Professor (Dept. of Obs & Gynecology),
SMS Medical College, Jaipur Rajasthan 302003, India
DOI: https://dx.doi.org/10.18535/jmscr/v6i5.78
