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Antepartum Haemorrhage
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Another conservative technique described is the ‘Triple P procedure’, which comprises of perioperative placental localisation and the delivery of the fetus via a transverse uterine incision above the upper border of the placenta; pelvic devascularization with temporary occlusive balloon catheters in the anterior division of the internal iliac arteries; and placental nonseparation with myometrial excision and reconstruction of the uterine wall. Modifications of the ‘Triple P procedure’, such as temporary clamping or ligation of the anterior division of internal iliac arteries, have been tried in centres with no access to interventional radiology. Uterine balloon tamponade has also been used successfully to control bleeding in these cases.
Profile of the Jada® System: the vacuum-induced hemorrhage control device for treating abnormal postpartum uterine bleeding and postpartum hemorrhage
Published in Expert Review of Medical Devices, 2021
Mary D’Alton, Kara Rood, Hyagriv Simhan, Dena Goffman
If these medications do not adequately control abnormal postpartum uterine bleeding or cannot be used in a patient due to contraindications, additional interventions are employed. For uterine atony, the next available intervention is often the insertion of a uterine balloon tamponade (UBT) device. Uterine balloon tamponade devices apply pressure directly to the vasculature by expanding against the inner walls of the uterus for 12 to 24 hours. If the abnormal postpartum uterine bleeding continues, more aggressive and increasingly invasive procedures may be indicated, including surgical interventions such as arterial ligation, compression sutures and hysterectomy.
Maternal outcomes following massive obstetric haemorrhage in an inner-city maternity unit
Published in Journal of Obstetrics and Gynaecology, 2019
Michael G. Fadel, Sayantana Das, Alexander Nesbitt, Kathryn Killicoat, Irene Gafson, Wasim Lodhi, Wai Yoong
We believe that our data adds a further depth to the evidence on BBT, especially in high-risk populations such as that served by our institution. A downside to the Cook Medical Bakri balloon is its cost, precluding its use in developing countries (Tindell et al. 2013). Rusch catheters and Sengstaken–Blakemore tubes, although not designed for obstetric use, are cheaper and may be of more use to the obstetric practitioner in the resource-poor setting. A further alternative is the development of a cheaper device for uterine balloon tamponade, an initiative that is currently being developed by PATH in collaboration with the Massachusetts General Hospital.
Bakri balloon for placenta accreta spectrum disorder: an alternative to caesarean hysterectomy?
Published in Journal of Obstetrics and Gynaecology, 2018
Shigeki Matsubara, Hironori Takahashi
Their data should be interpreted as follows: ‘if “partial/focal creta” is expected, placental removal followed by a Bakri balloon use may be attempted’. Recent advances in haemostatic procedures (including in Bakri) may have led to the re-introduction of an ‘extirpative approach’ for selected cases (Matsubara and Takahashi 2018). Pala et al. concluded that ‘in cases with ‘predicted placental detachment’, a uterine balloon tamponade is encouraging’. However, how we ‘predict placental detachment’ has yet to be determined. This is one of the important reasons why a CH hysterectomy is still a gold-standard treatment for the patients with PAS.