Postpartum Hemorrhage: Use of Bakri Balloon During Cesarean Delivery, a Case Report and Review

Abstract

The American College of Obstetricians and Gynecologists recently revised the definition of postpartum hemorrhage (PPH) to a cumulative blood loss of >=
1,000 mL (or) blood loss associated with signs or symptoms of hypovolemia within 24 h of the birth process. PPH is one leading cause of maternal mortality across the world. Prompt identification of the risk factors is proven to be helpful in earlier detection of PPH and is critical in preventing severe complications and related maternal morbidity and mortality. In this case report, we discuss a 29-year-old patient who had PPH at the time of cesarean delivery. This was effectively controlled by placement of an intraoperative Bakri balloon. The purpose of this review was to discuss and describe the indications and technique of Bakri balloon at the time of cesarean delivery complicated by PPH. Bakri balloon tamponade is usually indicated as a second-line treatment for severe PPH only when initial trials of bimanual compression of the uterus and uterotonic drugs fail to control bleeding. This appears to have minimal adverse effects on subsequent menstrual and reproductive function when intrauterine balloon tamponade is used for the management of severe PPH. Early use of intrauterine balloon tamponade is a way of effectively limiting ongoing uterine blood loss while initiating other measures, and can be readily implemented by providers with minimal training. Bakri balloon tamponade can be a life-saving intervention at the time of PPH and can reduce the need for a hysterectomy.




J Clin Gynecol Obstet. 2019;8(2):57-61
doi: https://doi.org/10.14740/jcgo556