Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact Study
Invasive therapies (surgery or radiological embolization) are used to control severe post-partum hemorrhage. The intra-uterine tamponade balloon is a potential alternative, well documented after vaginal delivery. However, available data on its use after cesarean delivery remain scarce. This study as...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/1/81 |
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| author | Mickaël Soued Alexandre J. Vivanti Daniel Smiljkovski Xavier Deffieux Alexandra Benachi Agnès Le Gouez Frédéric J. Mercier |
| author_facet | Mickaël Soued Alexandre J. Vivanti Daniel Smiljkovski Xavier Deffieux Alexandra Benachi Agnès Le Gouez Frédéric J. Mercier |
| author_sort | Mickaël Soued |
| collection | DOAJ |
| description | Invasive therapies (surgery or radiological embolization) are used to control severe post-partum hemorrhage. The intra-uterine tamponade balloon is a potential alternative, well documented after vaginal delivery. However, available data on its use after cesarean delivery remain scarce. This study assessed the efficacy of the intra-uterine tamponade balloon during post-partum hemorrhage in a cesarean delivery setting. Using a retrospective impact design, post-partum hemorrhage-related outcomes before (“pre-balloon” period) versus after implementation of intra-uterine tamponade balloon (“post-balloon” period) were compared. All women with post-partum hemorrhage requiring potent uterotonic treatment with prostaglandins after cesarean delivery over a 9-year period were eligible. The primary outcome was the rate of invasive procedure (conservative surgery, radiological embolization and/or hysterectomy). <i>p</i> < 0.05 was considered statistically significant. A total of 279 patients were included (140 vs. 139). Most baseline characteristics were comparable between the two studied periods. The success rate of the intra-uterine tamponade balloon was 82%, and no related complications occurred. Rates of invasive procedures and transfusion were significantly reduced (28.6% vs. 11.5%, <i>p</i> < 0.001 and 44.3% vs. 28.1%, <i>p</i> = 0.006 respectively) during the “post-balloon” period, and length of hospital stay was shorter (<i>p</i> < 0.001). Implementation of intra-uterine tamponade balloon during post-partum hemorrhage after cesarean delivery appears to be safe and effective, with a decrease in both invasive procedures and transfusion rates. |
| first_indexed | 2024-03-10T13:42:25Z |
| format | Article |
| id | doaj.art-38cf106749a94f1e99113fbb5b5b797e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T13:42:25Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-38cf106749a94f1e99113fbb5b5b797e2023-11-21T02:51:27ZengMDPI AGJournal of Clinical Medicine2077-03832020-12-011018110.3390/jcm10010081Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact StudyMickaël Soued0Alexandre J. Vivanti1Daniel Smiljkovski2Xavier Deffieux3Alexandra Benachi4Agnès Le Gouez5Frédéric J. Mercier6Department of Anesthesia, Hôpital Antoine Béclère, APHP, Université Paris Saclay, 157 rue de la Porte de Trivaux, 92140 Clamart, FranceDepartment of Gynecology and Obstetrics, Hôpital Antoine Béclère, APHP, Université Paris Saclay, 157 rue de la Porte de Trivaux, 92140 Clamart, FranceDepartment of Anesthesia, Hôpital Antoine Béclère, APHP, Université Paris Saclay, 157 rue de la Porte de Trivaux, 92140 Clamart, FranceDepartment of Gynecology and Obstetrics, Hôpital Antoine Béclère, APHP, Université Paris Saclay, 157 rue de la Porte de Trivaux, 92140 Clamart, FranceDepartment of Gynecology and Obstetrics, Hôpital Antoine Béclère, APHP, Université Paris Saclay, 157 rue de la Porte de Trivaux, 92140 Clamart, FranceDepartment of Anesthesia, Hôpital Antoine Béclère, APHP, Université Paris Saclay, 157 rue de la Porte de Trivaux, 92140 Clamart, FranceDepartment of Anesthesia, Hôpital Antoine Béclère, APHP, Université Paris Saclay, 157 rue de la Porte de Trivaux, 92140 Clamart, FranceInvasive therapies (surgery or radiological embolization) are used to control severe post-partum hemorrhage. The intra-uterine tamponade balloon is a potential alternative, well documented after vaginal delivery. However, available data on its use after cesarean delivery remain scarce. This study assessed the efficacy of the intra-uterine tamponade balloon during post-partum hemorrhage in a cesarean delivery setting. Using a retrospective impact design, post-partum hemorrhage-related outcomes before (“pre-balloon” period) versus after implementation of intra-uterine tamponade balloon (“post-balloon” period) were compared. All women with post-partum hemorrhage requiring potent uterotonic treatment with prostaglandins after cesarean delivery over a 9-year period were eligible. The primary outcome was the rate of invasive procedure (conservative surgery, radiological embolization and/or hysterectomy). <i>p</i> < 0.05 was considered statistically significant. A total of 279 patients were included (140 vs. 139). Most baseline characteristics were comparable between the two studied periods. The success rate of the intra-uterine tamponade balloon was 82%, and no related complications occurred. Rates of invasive procedures and transfusion were significantly reduced (28.6% vs. 11.5%, <i>p</i> < 0.001 and 44.3% vs. 28.1%, <i>p</i> = 0.006 respectively) during the “post-balloon” period, and length of hospital stay was shorter (<i>p</i> < 0.001). Implementation of intra-uterine tamponade balloon during post-partum hemorrhage after cesarean delivery appears to be safe and effective, with a decrease in both invasive procedures and transfusion rates.https://www.mdpi.com/2077-0383/10/1/81post-partum hemorrhagecesarean deliveryuterine balloon tamponadeembolizationhysterectomy |
| spellingShingle | Mickaël Soued Alexandre J. Vivanti Daniel Smiljkovski Xavier Deffieux Alexandra Benachi Agnès Le Gouez Frédéric J. Mercier Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact Study Journal of Clinical Medicine post-partum hemorrhage cesarean delivery uterine balloon tamponade embolization hysterectomy |
| title | Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact Study |
| title_full | Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact Study |
| title_fullStr | Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact Study |
| title_full_unstemmed | Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact Study |
| title_short | Efficacy of Intra-Uterine Tamponade Balloon in Post-Partum Hemorrhage after Cesarean Delivery: An Impact Study |
| title_sort | efficacy of intra uterine tamponade balloon in post partum hemorrhage after cesarean delivery an impact study |
| topic | post-partum hemorrhage cesarean delivery uterine balloon tamponade embolization hysterectomy |
| url | https://www.mdpi.com/2077-0383/10/1/81 |
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