Abstract
Postpartum hemorrhage is a growing medical problem associated with the clinically significant increase of postpartum hysterectomy rate. Currently physicians are making greater use of the uterine balloon tamponade method, a simple and efficacious approach towards managing bleeding in both vaginal and cesarean delivery.
This chapter presents an overview of the original Free Flow balloon tamponade method, the unique approach allowing for compression of hemorrhaging uterine vessels while preserving the restoration of uterine contractile function. In the majority of cases the complete cessation of bleeding is achieved within 30-40 min.
The joint application of autonomous uterine and vaginal catheters has made solving a dangerous inherent problem associated with the method, that of balloon expulsion, a possibility, along with significantly improving the success rate of lower segment uterine bleeding arrest with the addition of inter-balloon compression effect.
In cases of bleeding associated with vaginal lacerations the autonomous use of vaginal balloon provides adequate hemostasis when suturing is insufficient, while uniquely preserving the free outflow of lochia from the uterine cavity.
The application of double-balloon assembly system along with certain supplementary techniques, such as hemostatic external uterine supraplacental pleated sutures and bilateral ligation of the descending uterine artery branches, has been associated with a greater that fourfold drop in postpartum hysterectomy rates, simultaneously serving as a tool for early identification of patients in whom postpartum hysterectomy is indicated.
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Zhukovskiy, Y.G., Serova, O.F., Barinov, S.V. (2017). Postpartum Hemorrhage: Mechanical and Surgical Treatment. In: Malvasi, A., Tinelli, A., Di Renzo, G. (eds) Management and Therapy of Late Pregnancy Complications. Springer, Cham. https://doi.org/10.1007/978-3-319-48732-8_16
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