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Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effectiveness of routine rapid insertion of a Bakri balloon during cesarean section for placenta previa based on a retrospective control study.

Methods

Women with singleton pregnancies who underwent cesarean section for placenta previa at our institution between 2003 and 2016 were enrolled. Between 2015 and 2016, women who routinely underwent balloon tamponade during cesarean section were defined as the balloon group. Between 2003 and 2014, women who underwent no hemostatic procedures except balloon tamponade were defined as the non-balloon group. The clinical outcomes of the two groups were retrospectively analyzed.

Results

Of the 266 women with placenta previa, 50 were in the balloon group and 216 were in the non-balloon group. The bleeding amounts were significantly smaller in the balloon group than in the non-balloon group: intraoperative bleeding (991 vs. 1250 g, p < 0.01), postoperative bleeding (62 vs. 150 g, p < 0.01), and total bleeding (1066 vs. 1451 g, p < 0.01). Furthermore, the mean surgical duration was shorter in the balloon group than the non-balloon group (30 vs. 50 min, p < 0.01). In the balloon group, five patients suffered from increasing hemorrhage due to prolapse of the balloon from the uterus after the operation, but the hemorrhage was controlled by balloon re-insertion without additional hemostatic procedures.

Conclusions

This study demonstrated that the routine rapid insertion of Bakri balloon tamponade during cesarean section significantly decreased intra- and postoperative hemorrhage and shortened the surgical duration in women with placenta previa.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan

    Hiroaki Soyama, Morikazu Miyamoto, Hidenori Sasa, Hiroki Ishibashi, Masashi Yoshida, Masaya Nakatsuka, Masashi Takano & Kenichi Furuya

Authors
  1. Hiroaki Soyama
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  2. Morikazu Miyamoto
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  3. Hidenori Sasa
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  4. Hiroki Ishibashi
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  5. Masashi Yoshida
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  6. Masaya Nakatsuka
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  7. Masashi Takano
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  8. Kenichi Furuya
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Contributions

Author contributions

HS: Project development, data management and analysis, manuscript writing. MM: Project development, data management, manuscript editing. HS: Project development, data management. HI: Data collection and analysis. MY: Data collection. MN: Data collection. MT: Data collection. KF: Supervised all processes.

Corresponding author

Correspondence to Hiroaki Soyama.

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Funding

This study received no financial support.

Conflict of interest

The authors declare no conflicts of interest related to this study.

Ethical approval

This study was approved by the institutional review board of National Defense Medical College (Confirmation No. 2661). Date of approval: 20 February 2017.

Informed consent

Records/information of all women during the study period were completely anonymized and de-identified prior to analysis. This study was exempt from collecting informed consent from all participants.

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Soyama, H., Miyamoto, M., Sasa, H. et al. Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section. Arch Gynecol Obstet 296, 469–474 (2017). https://doi.org/10.1007/s00404-017-4446-1

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  • DOI: https://doi.org/10.1007/s00404-017-4446-1

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