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Federación Mexicana de Ginecología y Obstetricia, A.C.

2013, Number 08

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Ginecol Obstet Mex 2013; 81 (08)

Obstetric hemorrhage control Bakri balloon

Ortega-Castillo VMJ, Espino SS, Herrerías-Canedo T

Language: Spanish
References: 18
Page: 435-439
PDF size: 506.66 Kb.


ABSTRACT

Background: Obstetric hemorrhage is the second leading cause of maternal death in Mexico. Intrauterine tamponades are a valuable resource for the limitation of bleeding. Objective: Analyze the success rate of the Bakri balloon in the control of obstetric hemorrhage and calculate the fill volume with clinical parameters.
Material and Methods: Descriptive, retrospective and observational study Subjects were included who presented refractory hemorrhage on administration of uterotonics (postpartum, caesarean section, post-caesarean section, and post-miscarriage); a Bakri balloon was inserted with epidural anesthesia. The procedure was considered successful where there was immediate cessation of hemorrhage without recurrence. The fill volume in milliliters (FV) was analyzed with a linear regression that included gestational age in weeks (GA) and neonatal weight in grams (NW).
Results: The study included 35 subjects: 20 postpartum (57.1%), 10 caesarean and post-caesarean section (28.5%), and 5 post-miscarriage (14.2%). Use of the Bakri balloon was successful in 33 cases (94.2%). Unsuccessful cases involved subinvolution of the placental site and placenta accreta. Fill volume correlated with gestational age (r=0.50, p=0.001) and with neonatal weight (r=0.47, p=0.002). The linear regression equation for calculation of the fill volume is FV = 150 + (4.3 x GA) + (0.03 x NW), (p = 0.003).
Conclusion: Use of the Bakri balloon is safe, simple, and effective; we encountered no adverse reactions in this study. The procedure can be carried out after delivery or miscarriage or during or after a caesarean section.


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