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Balloon tamponade in the conservative management of postpartum haemorrhage resulting from placenta paevia
  1. S Islam1,
  2. A Pinto2,
  3. H Durrani3,
  4. L Gokhale3
  1. 1Nevill Hall Hospital, Abergavenny, UK
  2. 2Singleton Hospital, Swansae, UK
  3. 3Royal Gwent Hospital, Newport, UK

Abstract

Objective To report experience of management of postpartum haemorrhage (PPH) due to placenta praevia by the use of balloon temponade.

Methods A retrospective observational study of placenta praevia managed by balloon temponade for control of PPH at Caesarean section over 5-year period between 2004 and 2008 in Royal Gwent Hospital, Wales.

Results Thirty case notes of placenta praevia were reviewed. 22 patients (73%) developed PPH due either to lower uterine segment bleeding or a combination of uterine atony and lower segment bleeding. Balloon temponade was inserted for lower segment bleeding in 12 patients during Caesarean section (54% of cases with PPH) after failed medical management and ineffective lower segment haemostatic sutures. PPH was successfully controlled among all of them. Post temponade blood loss was between 20 and 250 ml only. None of the women underwent arterial ligation, embolization or hysterectomy. Among those who did not have balloon temponade, one woman had hysterectomy due to severe PPH of more than 4.5 l after ineffective medical management and haemostatic sutures.

Conclusion Our study showed encouraging results for the use of intrauterine balloon temponade at Caesarean section performed for placenta praevia in controlling severe PPH and avoiding any further invasive operative intervention.

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