Maternal outcomes after uterine balloon tamponade for postpartum hemorrhage.

OBJECTIVE: To evaluate maternal outcomes following uterine balloon tamponade in the management of postpartum hemorrhage.

DESIGN: Retrospective case-series.

SETTING: Two French hospitals, a level 3 university referral center and a level 2 private hospital.

POPULATION: All women who underwent balloon tamponade treatment for primary postpartum hemorrhage.

METHODS: Uterine tamponade was used after standard treatment of postpartum hemorrhage had failed. The study population was divided into two groups, successful cases where the bleeding stopped after the balloon tamponade, and failures requiring subsequent surgery or embolization.

MAIN OUTCOME MEASURES: Success rates.

RESULTS: Uterine tamponade was used in 49 women: 30 (61%) after vaginal delivery and 19 (39%) after cesarean section. Uterine atony was the main cause of hemorrhage (86%). The overall success rate was 65%. Of 17 failures, surgery was required in 16 cases, including hysterectomy in 11, and uterine artery embolization in one case. Demographic and obstetric characteristics did not differ significantly between the success and failure groups. No complications were directly attributed to the balloon tamponade in the postpartum period. Two women had a subsequent full-term pregnancy without recurrence of postpartum hemorrhage.

CONCLUSIONS: Balloon tamponade is an effective, safe and readily available method for treating primary postpartum hemorrhage and could reduce the need for invasive procedures.