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Is it worth to insert uterine pack instead of Bakri balloon to control postpartum hemorrhage after vaginal delivery in hypertensive patients?

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

An Editorial Expression of Concern to this article was published on 20 May 2023

This article has been updated

Abstract

Objective

To assess the safety and effectiveness of uterine packing with gauze compared to Bakri balloon to control postpartum hemorrhage (PPH) after vaginal delivery in patients with hypertensive disorders with pregnancy (HDP).

Methods

This was a prospective observational study conducted on 142 patients with HDP who suffered atonic PPH following vaginal delivery and were allocated either to insert uterine packing with gauze (n = 68) or insertion of Bakri balloon (n = 74). Success of the tamponade to arrest bleeding was the primary outcome measure. Data was collected and analyzed.

Results

Most of the included patients experienced spontaneous onset of labour (69%), had not receive I.V. antihypertensive drugs (83.1%) or magnesium sulphate (94.4%), or calcium channel blocker (95.7%), underwent spontaneous vaginal delivery (85.9%), received Pethidine by IMI for pain relief during labour (67.6%), did not need an episiotomy (59.2%), with spontaneous delivery of the placenta (95.77%). Bakri balloon was associated with a shorter duration to insert (p < 0.001), a higher failure rate with the need for laparotomy (p < 0.05) and more post-delivery hospital stay compared to uterine packing (p < 0.001).

Conclusion

Although uterine packing with gauze to control PPH after vaginal delivery in patients with HDP requires a longer time to insert compared to Bakri balloon yet associated with a lesser need for laparotomy and shorter hospital stay. Larger trials are warranted to confirm or refute these findings.

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Change history

  • 16 December 2022

    Editor’s Note: Readers are alerted that the reliability of data presented in this article is currently in question. Further editorial action will be taken as appropriate once the investigation into the concerns is complete and all parties have been given an opportunity to respond in full.

  • 20 May 2023

    An Editorial Expression of Concern to this paper has been published: https://doi.org/10.1007/s00404-023-07073-x

References

  1. Al-Zirqi I, Vangen S, Forsen L, Stray-Pedersen B (2008) Prevalence and risk factors of severe obstetric haemorrhage. BJOG 115:1265–1272

    Article  CAS  PubMed  Google Scholar 

  2. Oyelese Y, Ananth CV (2010) Postpartum hemorrhage: epidemiology, risk factors, and causes. Clin Obstet Gynecol 53:147–156

    Article  PubMed  Google Scholar 

  3. WHO (2012) WHO recommendations for the prevention and treatment of postpartum haemorrhage. World Health Organization, Geneva

    Google Scholar 

  4. Surbek D, Vial Y, Girard T, Breymann C, Bencaiova GA, Baud D, Hornung R, Taleghani BM, Hösli I (2020) Patient blood management (PBM) in pregnancy and childbirth: literature review and expert opinion. Arch Gynecol Obstet 301(2):627–641

    Article  PubMed  Google Scholar 

  5. Franke D, Zepf J, Burkhardt T, Stein P, Zimmermann R, Haslinger C (2021) Retained placenta and postpartum hemorrhage: time is not everything. Arch Gynecol Obstet 304(4):903–911

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Sheiner E, Sarid L, Levy A, Seidman SD, Hallak M (2005) Obstetric risk factors and outcome of pregnancies complicated with early postpartum hemorrhage: a population-based study. J Matern Fetal Neonatal Med 18:149–154

    Article  PubMed  Google Scholar 

  7. Eskild A, Vatten LJ (2009) Abnormal bleeding associated with preeclampsia: a population study of 315,085 pregnancies. Acta Obstet Gynecol Scand 88:154–158

    Article  PubMed  Google Scholar 

  8. Corine MK, van der Tuuk K, Groen H et al (2014) Prediction of postpartum hemorrhage in women with gestational hypertension or mild preeclampsia at term. Acta Obstet Gynecol Scand 93:399–407

    Article  Google Scholar 

  9. Wei J, Dai Y, Wang Z, Ning G, Hongfang J, Youdi X, Biyun X, Yali H (2020) Intrauterine double-balloon tamponade vs gauze packing in the management of placenta previa: a multicentre randomized controlled trial. Medicine 99(7):e19221

    Article  PubMed  PubMed Central  Google Scholar 

  10. Joshi BN, Shetty SS, Venkobrao K et al (2021) Cost-effectiveness of uterine balloon tamponade devices in managing atonic post-partum hemorrhage at public health facilities in India. PLoS ONE 16(8):e0256271

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Zwart JJ, Richters JM, Ory F, de Vries JIP, Bloemenkamp KWM, van Roosmalen J (2008) Severe maternal morbidity in the Netherlands: a nationwide population based cohort study of 371,000 pregnancies. BJOG 115:842–850

    Article  CAS  PubMed  Google Scholar 

  12. Combs CA, Murphy EL, Laros RK Jr (1991) Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol 77:69–76

    CAS  PubMed  Google Scholar 

  13. Ruiz MT, Azevedo CT, Ferreira MG, Mamede MV (2015) Association between hypertensive disorders and postpartum hemorrhage. Rev Gaúcha Enferm 36(spe):55–61

    Article  PubMed  Google Scholar 

  14. Ye C, Ruan Y, Zou L, Li G, Li C, Chen Y et al (2014) The 2011 survey on hypertensive disorders of pregnancy (HDP) in China: prevalence, risk factors, complications, pregnancy and perinatal outcomes. PLoS ONE 9(6):e100180

    Article  PubMed  PubMed Central  Google Scholar 

  15. World Health Organization (2014) Trends in maternal mortality: 1990 to 2013; estimates by WHO, UNICEF, UNFPA, The Bank and the United Nations Population Division. WHO, Geneva

    Google Scholar 

  16. Vasquez DN, Estenssoro E, Canaus HS, Reina R, Saenz MG, Neves AV et al (2007) Clinical characteristics and outcomes of obstetric patients requiring ICU admission. Chest 131(3):718–724

    Article  PubMed  Google Scholar 

  17. Labarta FJR, Recarte MPP et al (2021) Factors associated with failure of bakri balloon tamponade for the management of postpartum haemorrhage. Case series study and systematic review. healthcare 9(3):295

    Article  Google Scholar 

  18. Guo YN, Ma J, Wang XJ, Wang BS (2015) Does uterine gauze packing increase the risk of puerperal morbidity in the management of postpartum hemorrhage during caesarean section: a retrospective cohort study. Int J Clin Exp Med 8:13740–7

    CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to acknowledge the contribution of the residents and nursing staff of the emergency room, operating room, outpatient clinics, and delivery room at the two hospitals for their logistic support.

Funding

The authors have not disclosed any funding.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Menoufia University Hospital, Menoufia, Egypt

    Elsayed Elshamy, Mohamed Rezk & Abd-Elhamid Shaheen

  2. Department of Obstetrics and Gynecology, King Abdul-Aziz Airbase Hospital, 041/9 Prince Sattam street, Al-Khobar, Dhahran, Saudi Arabia

    Elsayed Elshamy

  3. Department of Obstetrics and Gynecology, Rabia Hospital, Riyadh, Saudi Arabia

    Mohamed Rezk

Authors
  1. Elsayed Elshamy
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  2. Mohamed Rezk
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  3. Abd-Elhamid Shaheen
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Contributions

EE: project development, follow-up of cases, data collection and manuscript writing. MR: project development, data collection, manuscript writing. AS: project development and data analysis and manuscript writing.

Corresponding author

Correspondence to Elsayed Elshamy.

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Non-declared.

Ethical approval

All procedures performed in the current study involving human participants were in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments in 2000.

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Informed consent was obtained from all individual participants included in the study.

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Elshamy, E., Rezk, M. & Shaheen, AE. Is it worth to insert uterine pack instead of Bakri balloon to control postpartum hemorrhage after vaginal delivery in hypertensive patients?. Arch Gynecol Obstet 307, 1195–1201 (2023). https://doi.org/10.1007/s00404-022-06543-y

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  • DOI: https://doi.org/10.1007/s00404-022-06543-y

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