Uterine balloon volume shifts using a free-flow uterine balloon in the management of refractory postpartum haemorrhage.
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Abstract
Background. Uterine balloon tamponade (UBT) is used as part of the post partum haemorrhage (PPH) algorithm for the treatment of PPH. Objectives. The free-flow Ellavi uterine balloon controls the pressure in the uterine balloon by adjusting the height of the supply bag above the patient and allows for expulsion of water from the balloon. The study quantified the volume shifts in the supply bag and assessed the optimal use of the Ellavi UBT by reducing the intrauterine pressure at regular intervals.
Methods. A prospective descriptive study of consecutive patients with refractory PPH was conducted. For group A, the supply bag was weighed every 30 minutes with a sensitive digital scale. Additionally, for group B the supply bag was lowered by 50% and the uterus gently massaged for 30 seconds.
Results. Thirteen patients were included in the study. The mean volume was 23.5 mL for Group A and 132.7 mL for Group B. The difference in the means of groups A and B was borderline significant (p=0.06).
Conclusion. The study did find volume shifts in the free-flow system, which may be enhanced by lowering the supply bag halfway at regular intervals.
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References
Moodley J, Fawcus S, Pattinson R. Improvements in maternal mortality in South Africa. S Afr Med J 2018;108(3):4-8.
Weeks AD, Akinola OI, Amorim M, et al.. World Health Organization recommendation for using uterine balloon tamponade to treat postpartum haemorrhage. Obstet Gynaecol 2022 Mar;139(3):458- 462. https://doi.org/10.1097/aog.0000000000004674
Bakri YN, Arulkumaran S. Intrauterine balloon tamponade for control of Postpartum haemorrhage 2013. 26 Sept 2017. www.uptodate.com/contents/intrauterine-balloon-tamponade-for-control-of- postpartum-hemorrhage (25/05/2020).
Ayres-de-Campos D, Stones W, Theron GB. Affordable and low-maintenance obstetric devices. Int J Gynecol Obstet 2019;146:25-28. https://doi.org/10.1002/ijgo.12838
Theron, G. B., & Mpumlwana, V. (2021). A case series of post-partum haemorrhage managed using ellavi uterine balloon tamponade in a rural regional hospital. South African Family Practice, 63(1), 1–4. https://doi.org/10.4102/safp.v63i1.5266
Georgiou C. Intraluminal pressure readings during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage. An Int J Obstet Gynaecol 2010;117(3):295-303. https://doi.org/10.1111/j.1471-0528.2009.02436.x
Laas E, Bui C, Popowski T, Mbaku OM, Rozenberg P. Trends in the rate of invasive procedures after the addition of the intrauterine tamponade test to a protocol for management of severe postpartum haemorrhage. Am J Obstet Gynaecol 2012:207(4):281-e1-7. https://doi.org/10.1016/j. ajog.2012.08.028
Revert M, Cottenet J, Raynal P, Cibot E, Quantin C, Rozenberg P. Intrauterine balloon tamponade for management of severe postpartum haemorrhage in a perinatal network: A prospective cohort study. Int J Obstet Gynaecol 2017;124(8):1255-1262. https://doi.org/10.1111/1471-0528.14382