China
Africa
Explore chapters and articles related to this topic
Postpartum hemorrhage
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Wade D. Schwendemann, William J. Watson
If rare causes of postpartum hemorrhage have been ruled out and standard medical therapies have failed to relieve the bleeding, further intervention is required. Which method one chooses will be largely based on the method of delivery. In a vaginal delivery, if the patient has not been transported to the operating suite, this should be done. The room should be prepared for the possibility of an emergent laparotomy. Consideration should be given to the idea of uterine tamponade prior to surgical intervention. Packing of the uterus is one method (26–28), although newer techniques have replaced it to a large extent. The Bakri balloon was developed specifically for this purpose (29). The balloon must be inserted completely into the uterine cavity and inflated with 300 to 500 cc of saline. Care should be taken to ensure that the balloon does not cross the cervical os, as this placement will not be effective and could cause cervical trauma.
Primary Postpartum Haemorrhage
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Malik Goonewardene
Formerly, uterine tamponade was achieved by packing the uterus with wide, rolled gauze. This has been superseded by the use of balloon tamponade. Balloon tamponade was first attempted with the Sengstaken-Blakemore oesophageal catheter or the Rusch urological balloon. Subsequently, the Bakri balloon was specifically designed for the purpose of uterine tamponade. Balloon tamponade is a simple and relatively noninvasive procedure that can be performed in the labour room, and it does not require anaesthesia. It will often immediately reduce or stop the bleeding and avert the need for laparotomy. The principle of balloon tamponade is to apply direct pressure on the uteroplacental vessels that are exposed after placental separation so that, once the bleeding stops, blood can clot and form a permanent seal. Therefore, the pressure applied should be greater than the pressure of blood flow in the uteroplacental vessels. The uterine cavity should be empty of blood clots or placental tissue in order for balloon tamponade to be effective.
Surgical Management of Placenta Accreta
Published in Robert M. Silver, Placenta Accreta Syndrome, 2017
William M. Burke, Annette Perez-Delboy, Jason D. Wright
If an unexpected placenta accreta is encountered intraoperatively that cannot be resolved quickly with placental extraction and fertility is desired, placement of a Bakri balloon or Foley catheter balloon to provide compression can be attempted.63,64 Additional hemorrhage prevention strategies used in second-trimester cases include use of uterotonics and uterine massage.63 If none of the steps for postabortal hemorrhage is successful and UAE is unavailable or unsuccessful, hysterectomy should be performed. The operating room should be prepared with instrumentation and staffing for hysterectomy in all patients with suspicious imaging findings who undergo D&E.
Comparison of results of Bakri balloon tamponade and caesarean hysterectomy in management of placenta accreta and increta: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2018
Şehmus Pala, Remzi Atilgan, Melike Başpınar, Ebru Çelik Kavak, Şeyda Yavuzkır, Alparslan Akyol, Burçin Kavak
The Bakri balloon is an intrauterine device that reduces or controls PPH when conservative treatment is needed. It seems to be an effective device for the management of acute PPH refractory to medical treatment, and minimal training is needed for its use. The device consists of a silicone balloon attached to a catheter. The deflated balloon is inserted into the uterine cavity, and when filled with liquid takes the shape of the cavity and stops the bleeding. The central lumen of the catheter provides blood drainage, thus blood loss can be evaluated. The main advantages defined for the Bakri balloon are its simply transabdominal or transvaginal insertion, which provides a quick tamponade of the uterine cavity, easily controls bleeding and avoids more invasive procedures such as hysterectomy (Bakri et al. 2001).
Use of Bakri balloon tamponade (BBT) for conservative management of postpartum haemorrhage: a tertiary referral centre case series
Published in Journal of Obstetrics and Gynaecology, 2018
Manisha Mathur, Qiu Ju Ng, Shephali Tagore
There were 10 women with suspicion of undiagnosed focal morbidly adherent placenta during the surgery. In these patients, the Bakri Balloon was used to manage PPH after the removal of the placenta but it failed in five women, who then required hysterectomies. The histopathological reports confirmed the presence of morbidly adherent placenta in these patients. In the remaining five patients, the Bakri balloon was successful in managing PPH. In our opinion, the Bakri balloon was effective as tamponade for the bleeding from the placental bed.
Bakri Balloon: an easy, useful and effective option for the treatment of postpartum haemorrhage
Published in Journal of Obstetrics and Gynaecology, 2022
Maria-Jesús Puente-Luján, Maria-Pilar Andrés-Orós, Leticia Álvarez-Sarrado, Andrea Agustín-Oliva, Isabel González-Ballano, Belén Rodríguez-Solanilla, Sergio Castán-Mateo
Bakri Balloon was originally developed for treating haemorrhages due to abnormal placentation in the lower uterine segment (placenta accreta and placenta previa) (Bakri et al. 2001; Jauniaux et al. 2019). Subsequently, its use has been extended to PPH induced by other causes including uterine atony, endometritis or even coagulopathies (Georgiou 2012). The effectiveness varies depending on the literature consulted ranging from 67% to 90% in the most recent series (Kaya et al. 2014).