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Am J Perinatol 2017; 34(02): 164-168
DOI: 10.1055/s-0036-1585084
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Is There an Association Between Indication for Intrauterine Balloon Tamponade and Balloon Failure?

Moeun Son
1   Division of Maternal-Fetal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
,
Brett D. Einerson
2   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah
,
Patrick Schneider
3   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Chicago School of Medicine, Chicago, Illinois
,
Ian C. Fields
4   Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
,
William A. Grobman
1   Division of Maternal-Fetal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
,
Emily S. Miller
1   Division of Maternal-Fetal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

19 April 2016

01 June 2016

Publication Date:
01 July 2016 (online)

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Abstract

Objective Determine whether the indication for intrauterine balloon tamponade (IUBT) is associated with failure rates.

Study Design Cohort study of women who underwent IUBT for postpartum hemorrhage (PPH) from 2007 to 2014. The indication was categorized as uterine atony or placental-site bleeding. Primary outcome was IUBT failure, defined as the need for uterine artery embolization or hysterectomy. Secondary outcomes were estimated blood loss (EBL) after balloon placement, transfusion of red blood cells (RBC), transfusion of fresh frozen plasma (FFP) and/or cryoprecipitate, and intensive care unit (ICU) admission.

Results 306 women underwent IUBT: 241 (78.8%) for uterine atony and 65 (21.2%) for placental site bleeding. Overall, 67 (21.9%) women experienced IUBT failure. The frequency of failure was similar in those with uterine atony compared with those with placental-site bleeding (21.2 vs 24.6%, p = 0.55). This finding persisted after adjusting for potential confounders (aOR, 0.97; 95% CI, 0.48–1.99). Median EBL after balloon placement (190 [interquartile range, 93–375] vs 195 [interquartile range, 103–500] mL, p = 0.46), and frequencies of RBC transfusion (62.7 vs 66.2%, p = 0.60), FFP and/or cryoprecipitate transfusion (25.3 vs 33.8%, p = 0.17), and ICU admission (12.4 vs 16.9%, p = 0.35) were also similar.

Conclusion IUBT was similarly effective for managing PPH from uterine atony or placental-site bleeding.

Keywords

postpartum hemorrhage - intrauterine balloon tamponade - uterine atony - placental site bleeding

Note

This study was presented at the 36th annual meeting of the Society for Maternal–Fetal Medicine, Atlanta, GA, February 1 to 6, 2016.


 

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