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The following is a summary of “Effectiveness of the Intrauterine Balloon Tamponade Compared With an Intrauterine, Vacuum-Induced, Hemorrhage-Control Device for Postpartum Hemorrhage,” published in the October 2024 issue of Obstetrics and Gynecology by Shields et al.
Postpartum hemorrhage (PPH) is a significant cause of maternal morbidity and mortality, necessitating effective intervention strategies.
Researchers conducted a prospective study to compare intrauterine balloon tamponade and vacuum-induced hemorrhage-control devices for PPH management.
They collected data through detailed hemorrhage case audits across 65 facilities (August 2022 to February 2024), PPH-control devices were utilized for stage 2 or 3 of the PPH response algorithm.
The results showed 123,292 deliveries, PPH occurred in 5,931 (4.8%) cases, with hemorrhage-control devices used in 666 cases (intrauterine balloon tamponade n=300 and vacuum-induced hemorrhage-control device n=366). Quantitative blood loss after device placement was similar, 194 (67–440) mL for intrauterine balloon tamponade and 240 (113–528) mL for vacuum-induced hemorrhage-control devices (P=.40). The rates of packed red blood cell transfusion were 59.7% for intrauterine balloon tamponade, and 50.0% for vacuum-induced hemorrhage-control devices (P=.08), with 27.0% vs. 24.9% requiring 3 or more units of packed red blood cells (P=.53), and device failure rates were 7.7% and 8.5%, respectively (P=.70). Placement of either device when blood loss was between 1,000 and 1,499 mL significantly reduced the rates of packed red blood cell transfusion (39.1% vs. 70.3%, P<.001), transfusion of 3 or more packed red blood cell units (13.7% vs. 38.1%, P<.001), and device failure (3.4% vs. 12.9%, P<.001).
They concluded that both hemorrhage-control devices showed similar outcomes regarding transfusion needs and blood loss, with earlier Placement leading to reduced device failure and transfusion requirements.
Source: journals.lww.com/greenjournal/abstract/9900/effectiveness_of_the_intrauterine_balloon.1171.aspx