The Low Cost Intra-Uterine Balloon: An Innovative, Safe and Suitable Solution for Immediate Post-Partum Hemorrhagia (Hppi) By Uterine Atonia in Countries with Limited Resources Volume 4 - Issue 3

MM Niang*, A Mbodji, F Samb, M Thiam, ED Sy and CT Cisse

• Department of Obstetrics and Gynecology Hospital Institute of Social Hygiene of Dakar (Senegal)

Received:August 4, 2021Published: August 17, 2021

Corresponding author:Pr Mouhamadou Mansour NIANG, Associate Professor, Cheikh Anta Diop University of Dakar.

DOI: 10.32474/IGWHC.2021.04.000196

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Abstract

Objectives: To assess the efficacy and safety of the low-cost intrauterine balloon in the management of immediate postpartum hemorrhage from uterine atony persisting after medical treatment.

Material and methods: This was a multicenter, prospective and descriptive study carried out between March 1, 2014 and August 31, 2016 (30 months) and concerning patients who presented an immediate postpartum hemorrhage by uterine atony and taken in load by the intrauterine balloon.

Results: Fifty patients met our inclusion criteria. They were on average 27 years old with an average parity of 2 and an average number of living children of 2. The intrauterine balloon was placed within an average of 2 hours 17 minutes after childbirth and removed in average 13 hours 58 minutes later. At the time of balloon insertion, 15 patients were in cardiovascular collapse, 13 of them with altered consciousness. Uterotonics were used for prophylaxis in all patients. The other therapeutic procedures performed before placing the intrauterine balloon were uterine massage (45/50), uterine revision (24/50), sutures of perineal lesions (18/50), bimanual compression (5 / 50) and the use of misoprostol (50/50). After insertion of the intrauterine balloon, 28 out of 50 patients (56%) received a blood transfusion. We had 90% success with stopping the bleeding and performed 4 hemostatic hysterectomies (8%). One case of acute anuric renal failure was noted and two maternal deaths recorded, for a case fatality of 2%. Conclusion: The intrauterine balloon appears to be an effective, safe and accessible means for the management of immediate postpartum hemorrhage from uterine atony in resource-limited settings.

Keywords: Maternal mortality; postpartum hemorrhage; uterine atony; intrauterine balloon

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