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Amat Pérez R, Gómez Valdés J, Lonjedo Vicent E, Sarrió Llavata M, Quirante Cascales J, Ruiz Guanter A. Eficacia y seguridad de la embolización de arterias uterinas en el manejo de la hemorragia posparto. RADIOLOGIA 2023. [DOI: 10.1016/j.rx.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Püchel J, Sitter M, Kranke P, Pecks U. Procedural techniques to control postpartum hemorrhage. Best Pract Res Clin Anaesthesiol 2022; 36:371-382. [PMID: 36513432 DOI: 10.1016/j.bpa.2022.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Abstract
Postpartum hemorrhage can occur unexpectedly and with high dynamics. The mother's life often depends on quick action and good communication within an interdisciplinary team. Knowledge of each other's therapeutic options plays a major role. Treatment procedures include obstetric, surgical, and radiologic techniques. In addition to availability and experience with the techniques, two important aspects must be considered in the selection process: the type of delivery and the cause of the hemorrhage. In particular, the distinction between pregnancies with or without disturbed placentation from the placenta accreta spectrum is crucial. From these two points of view, we discuss here different uterus-preserving and uterus-removing techniques. We describe in detail the advantages and disadvantages of each procedure. Because most therapeutic options are based on small case series and uncontrolled studies, local circumstances and physician experience are critical in setting internal standards.
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Affiliation(s)
- Jodok Püchel
- Department of Gynaecology and Obstetrics, University Hospital of Cologne, Germany.
| | - Magdalena Sitter
- Department of Anaesthesia, Critical Care Medicine, Emergency Medicine and Pain Medicine, University Hospital of Wuerzburg, Germany.
| | - Peter Kranke
- Department of Anaesthesia, Critical Care Medicine, Emergency Medicine and Pain Medicine, University Hospital of Wuerzburg, Germany.
| | - Ulrich Pecks
- Department of Gynaecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
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Anger HA, Durocher J, Dabash R, Hassanein N, Ononge S, Burkhardt G, Frye LJ, Diop A, Beye Diop SBM, Darwish E, Ramadan MC, Kayaga J, Charles D, Gaye A, Eckardt M, Winikoff B. Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade. PLoS One 2021; 16:e0245988. [PMID: 33556104 PMCID: PMC7869979 DOI: 10.1371/journal.pone.0245988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 01/11/2021] [Indexed: 11/29/2022] Open
Abstract
Objective We aimed to determine the risk of postpartum infection and increased pain associated with use of condom-catheter uterine balloon tamponade (UBT) among women diagnosed with postpartum hemorrhage (PPH) in three low- and middle-income countries (LMICs). We also sought women’s opinions on their overall experience of PPH care. Methods This prospective cohort study compared women diagnosed with PPH who received and did not receive UBT (UBT group and no-UBT group, respectively) at 18 secondary level hospitals in Uganda, Egypt, and Senegal that participated in a stepped wedge, cluster-randomized trial assessing UBT introduction. Key outcomes were reported pain (on a scale 0–10) in the immediate postpartum period and receipt of antibiotics within four weeks postpartum (a proxy for postpartum infection). Outcomes related to satisfaction with care and aspects women liked most and least about PPH care were also reported. Results Among women diagnosed with PPH, 58 were in the UBT group and 2188 in the no-UBT group. Self-reported, post-discharge antibiotic use within four weeks postpartum was similar in the UBT (3/58, 5.6%) and no-UBT groups (100/2188, 4.6%, risk ratio = 1.22, 95% confidence interval [CI]: 0.45–3.35). A high postpartum pain score of 8–10 was more common among women in the UBT group (17/46, 37.0%) than in the no-UBT group (360/1805, 19.9%, relative risk ratio = 3.64, 95% CI:1.30–10.16). Most women were satisfied with their care (1935/2325, 83.2%). When asked what they liked least about care, the most common responses were that medications (580/1511, 38.4%) and medical supplies (503/1511, 33.3%) were unavailable. Conclusion UBT did not increase the risk of postpartum infection among this population. Women who receive UBT may experience higher degrees of pain compared to women who do not receive UBT. Women’s satisfaction with their care and stockouts of medications and other supplies deserve greater attention when introducing new technologies like UBT.
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Affiliation(s)
- Holly A. Anger
- Gynuity Health Projects, New York, New York, United States of America
- * E-mail:
| | - Jill Durocher
- Gynuity Health Projects, New York, New York, United States of America
| | - Rasha Dabash
- Gynuity Health Projects, New York, New York, United States of America
| | | | - Sam Ononge
- Makerere University School of Health Sciences, Kampala, Uganda
| | - Gillian Burkhardt
- Gynuity Health Projects, New York, New York, United States of America
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Laura J. Frye
- Gynuity Health Projects, New York, New York, United States of America
| | - Ayisha Diop
- Gynuity Health Projects, New York, New York, United States of America
| | | | - Emad Darwish
- Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | | | - Dyanna Charles
- Gynuity Health Projects, New York, New York, United States of America
| | - Alioune Gaye
- Obstetrician/Gynecologist Consultant, Dakar, Senegal
| | - Melody Eckardt
- Global Health Innovation Lab, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Beverly Winikoff
- Gynuity Health Projects, New York, New York, United States of America
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Corvino F, Giurazza F, Vallone M, Mosca S, Fischer MJ, Corvino A, Niola R. Postpartum Hemorrhage: Rescue. Semin Ultrasound CT MR 2021; 42:75-84. [PMID: 33541591 DOI: 10.1053/j.sult.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Severe postpartum hemorrhage (PPH) occurs in around 1%-2% of deliveries and is a leading cause of maternal mortality and morbidity worldwide. Different treatments of PPH are proposed by the scientific society's guidelines; to date, pelvic artery embolization is an effective therapeutic strategy with the advantages of fast speed, repeatability, and the possibility of future fertility preservation. We compared the different PPH treatments, focusing especially on the role of interventional radiology reviewing pelvic vascular anatomy and emphasizing on the timing of embolization and various clinical conditions of PPH.
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Affiliation(s)
- Fabio Corvino
- Interventional Radiology Department, AORN "A. Cardarelli," Naples, Italy.
| | - Francesco Giurazza
- Interventional Radiology Department, AORN "A. Cardarelli," Naples, Italy
| | - Mario Vallone
- Radiology Department, "Ospedale Civico Di Cristina e Benfratelli," Palermo, Italy
| | - Stefano Mosca
- Interventional Radiology Department, "Ospedale Santa Maria della Misericordia di Perugia," Perugia, Italy
| | - Matthias Joachim Fischer
- Interventional Radiology Department, "Ospedale Santa Maria della Misericordia di Perugia," Perugia, Italy
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope,", Naples, Italy
| | - Raffaella Niola
- Interventional Radiology Department, AORN "A. Cardarelli," Naples, Italy
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Suarez S, Conde-Agudelo A, Borovac-Pinheiro A, Suarez-Rebling D, Eckardt M, Theron G, Burke TF. Uterine balloon tamponade for the treatment of postpartum hemorrhage: a systematic review and meta-analysis. Am J Obstet Gynecol 2020; 222:293.e1-293.e52. [PMID: 31917139 DOI: 10.1016/j.ajog.2019.11.1287] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess the efficacy, effectiveness, and safety of uterine balloon tamponade for treating postpartum hemorrhage. STUDY DESIGN We searched electronic databases (from their inception to August 2019) and bibliographies. We included randomized controlled trials, nonrandomized studies, and case series that reported on the efficacy, effectiveness, and/or safety of uterine balloon tamponade in women with postpartum hemorrhage. The primary outcome was the success rate of uterine balloon tamponade for treating postpartum hemorrhage (number of uterine balloon tamponade success cases/total number of women treated with uterine balloon tamponade). For meta-analyses, we calculated pooled success rate for all studies, and relative risk with 95% confidence intervals for studies that included a comparative arm. RESULTS Ninety-one studies, including 4729 women, met inclusion criteria (6 randomized trials, 1 cluster randomized trial, 15 nonrandomized studies, and 69 case series). The overall pooled uterine balloon tamponade success rate was 85.9% (95% confidence interval, 83.9-87.9%). The highest success rates corresponded to uterine atony (87.1%) and placenta previa (86.8%), and the lowest to placenta accreta spectrum (66.7%) and retained products of conception (76.8%). The uterine balloon tamponade success rate was lower in cesarean deliveries (81.7%) than in vaginal deliveries (87.0%). A meta-analysis of 2 randomized trials that compared uterine balloon tamponade vs no uterine balloon tamponade in postpartum hemorrhage due to uterine atony after vaginal delivery showed no significant differences between the study groups in the risk of surgical interventions or maternal death (relative risk, 0.59; 95% confidence interval, 0.02-16.69). A meta-analysis of 2 nonrandomized before-and-after studies showed that introduction of uterine balloon tamponade in protocols for managing severe postpartum hemorrhage significantly decreased the use of arterial embolization (relative risk, 0.29; 95% confidence interval, 0.14-0.63). A nonrandomized cluster study reported that use of invasive procedures was significantly lower in the perinatal network that routinely used uterine balloon tamponade than that which did not use uterine balloon tamponade (3.0/1000 vs 5.1/1000; P < .01). A cluster randomized trial reported that the frequency of postpartum hemorrhage-related invasive procedures and/or maternal death was significantly higher after uterine balloon tamponade introduction than before uterine balloon tamponade introduction (11.6/10,000 vs 6.7/10,000; P = .04). Overall, the frequency of complications attributed to uterine balloon tamponade use was low (≤6.5%). CONCLUSION Uterine balloon tamponade has a high success rate for treating severe postpartum hemorrhage and appears to be safe. The evidence on uterine balloon tamponade efficacy and effectiveness from randomized and nonrandomized studies is conflicting, with experimental studies suggesting no beneficial effect, in contrast with observational studies. Further research is needed to determine the most effective programmatic and healthcare delivery strategies on uterine balloon tamponade introduction and use.
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Affiliation(s)
- Sebastian Suarez
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Internal Medicine, Boston Medical Center, Boston, Massachusetts.
| | - Agustin Conde-Agudelo
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan
| | - Anderson Borovac-Pinheiro
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas (SP), Brazil
| | - Daniela Suarez-Rebling
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Melody Eckardt
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Gerhard Theron
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Thomas F Burke
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Ramanathan A, Eckardt MJ, Nelson BD, Guha M, Oguttu M, Altawil Z, Burke T. Safety of a condom uterine balloon tamponade (ESM-UBT) device for uncontrolled primary postpartum hemorrhage among facilities in Kenya and Sierra Leone. BMC Pregnancy Childbirth 2018; 18:168. [PMID: 29764416 PMCID: PMC5952618 DOI: 10.1186/s12884-018-1808-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postpartum hemorrhage is the leading cause of maternal mortality in low- and middle-income countries. While evidence on uterine balloon tamponade efficacy for severe hemorrhage is encouraging, little is known about safety of this intervention. The objective of this study was to evaluate the safety of an ultra-low-cost uterine balloon tamponade package (named ESM-UBT) for facility-based management of uncontrolled postpartum hemorrhage (PPH) in Kenya and Sierra Leone. METHODS Data were collected on complications/adverse events in all women who had an ESM-UBT device placed among 92 facilities in Sierra Leone and Kenya, between September 2012 and December 2015, as part of a multi-country study. Three expert maternal health investigator physicians analyzed each complication/adverse event and developed consensus on whether there was a potential causal relationship associated with use of the ESM-UBT device. Adverse events/complications specifically investigated included death, hysterectomy, uterine rupture, perineal or cervical injury, serious or minor infection, and latex allergy/anaphylaxis. RESULTS Of the 201 women treated with an ESM-UBT device in Kenya and Sierra Leone, 189 (94.0%) survived. Six-week or longer follow-up was recorded in 156 of the 189 (82.5%). A causal relationship between use of an ESM-UBT device and one death, three perineal injuries and one case of mild endometritis could not be completely excluded. Three experts found a potential association between these injuries and an ESM-UBT device highly unlikely. CONCLUSION The ESM-UBT device appears safe for use in women with uncontrolled PPH. TRIAL REGISTRATION Trial registration was not completed as data was collected as a quality assurance measure for the ESM-UBT kit.
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Affiliation(s)
- Aparna Ramanathan
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA. .,Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Melody J Eckardt
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA
| | - Brett D Nelson
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA.,Harvard Medical School, Boston, MA, USA
| | - Moytrayee Guha
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA
| | | | - Zaid Altawil
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA
| | - Thomas Burke
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua St, Suite 910, Boston, MA, 02114, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Guo Y, Hua R, Bian S, Xie X, Ma J, Cai Y, Sooranna SR, Cheng W. Intrauterine Bakri Balloon and Vaginal Tamponade Combined with Abdominal Compression for the Management of Postpartum Hemorrhage. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 40:561-565. [DOI: 10.1016/j.jogc.2017.08.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/19/2017] [Accepted: 08/21/2017] [Indexed: 10/18/2022]
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Yorifuji T, Takeda J, Makino S, Tanaka T, Itakura A, Takeda S. Evaluation of the effectiveness of metreurynters for balloon tamponade. HYPERTENSION RESEARCH IN PREGNANCY 2018. [DOI: 10.14390/jsshp.hrp2018-001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Takashi Yorifuji
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine
| | - Jun Takeda
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine
| | - Shintaro Makino
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine
| | - Toshitaka Tanaka
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine
| | - Atsuo Itakura
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine
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9
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Lindquist JD, Vogelzang RL. Pelvic Artery Embolization for Treatment of Postpartum Hemorrhage. Semin Intervent Radiol 2018; 35:41-47. [PMID: 29628615 PMCID: PMC5886774 DOI: 10.1055/s-0038-1636520] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Postpartum hemorrhage (PPH) is the leading cause of maternal perinatal morbidity and mortality worldwide. Defined as greater than 500 mL blood loss after vaginal delivery, and greater than 1,000 mL blood loss after cesarean delivery, PPH has many causes, including uterine atony, lower genital tract lacerations, coagulopathy, and placental anomalies. Correction of coagulopathy and identification of the cause of bleeding are mainstays of treatment. Medical therapies such as uterotonics, balloon tamponade, pelvic artery embolization, and uterine-sparing surgical options are available. Hysterectomy is performed when conservative therapies fail. Pelvic artery embolization is safe and effective, and is the first-line therapy for medically refractory PPH. A thorough knowledge of pelvic arterial anatomy is critical. Recognition of variant anatomy can prevent therapeutic failure. Pelvic embolization is minimally invasive, has a low complication rate, spares the uterus, and preserves fertility.
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Affiliation(s)
- Jonathan D. Lindquist
- Division of Interventional Radiology, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Robert L. Vogelzang
- Division of Vascular and Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital and McGaw Medical Center, Chicago, Illinois
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Chen T, Xu XQ, Shi HB, Yang ZQ, Zhou X, Pan Y. Conventional MRI features for predicting the clinical outcome of patients with invasive placenta. Diagn Interv Radiol 2018; 23:173-179. [PMID: 28345524 DOI: 10.5152/dir.2016.16412] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate whether morphologic magnetic resonance imaging (MRI) features could help to predict the maternal outcome after uterine artery embolization (UAE)-assisted cesarean section (CS) in patients with invasive placenta previa. METHODS We retrospectively reviewed the MRI data of 40 pregnant women who have undergone UAE-assisted cesarean section due to suspected high risk of massive hemorrhage caused by invasive placenta previa. Patients were divided into two groups based on the maternal outcome (good-outcome group: minor hemorrhage and uterus preserved; poor-outcome group: significant hemorrhage or emergency hysterectomy). Morphologic MRI features were compared between the two groups. Multivariate logistic regression analysis was used to identify the most valuable variables, and predictive value of the identified risk factor was determined. RESULTS Low signal intensity bands on T2-weighted imaging (P < 0.001), placenta percreta (P = 0.011), and placental cervical protrusion sign (P = 0.002) were more frequently observed in patients with poor outcome. Low signal intensity bands on T2-weighted imaging was the only significant predictor of poor maternal outcome in multivariate analysis (P = 0.020; odds ratio, 14.79), with 81.3% sensitivity and 84.3% specificity. CONCLUSION Low signal intensity bands on T2-weighted imaging might be a predictor of poor maternal outcome after UAE-assisted cesarean section in patients with invasive placenta previa.
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Affiliation(s)
- Ting Chen
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Takahashi H, Ohkuchi A, Usui R, Suzuki H, Baba Y, Matsubara S. Matsubara-Takahashi cervix-holding technique for massive postpartum hemorrhage in patients with placenta previa with or without placenta accreta spectrum disorders. Int J Gynaecol Obstet 2017; 140:357-364. [DOI: 10.1002/ijgo.12390] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/12/2017] [Accepted: 11/15/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Hironori Takahashi
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Akihide Ohkuchi
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Rie Usui
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Hirotada Suzuki
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Yosuke Baba
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
| | - Shigeki Matsubara
- Department of Obstetrics and Gynecology; Jichi Medical University; Shimotsuke Tochigi Japan
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George R, Ola B. Bilateral hydronephrosis following uterine balloon tamponade in a case of massive post-partum haemorrhage with coagulopathy. J OBSTET GYNAECOL 2017; 37:807-808. [PMID: 28553730 DOI: 10.1080/01443615.2017.1312301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Roshni George
- a Department of Obstetrics and Gynaecology , Jessop Wing, Sheffield Teaching, Hospital NHS Foundation Trust , Sheffield , UK
| | - Bolarinde Ola
- a Department of Obstetrics and Gynaecology , Jessop Wing, Sheffield Teaching, Hospital NHS Foundation Trust , Sheffield , UK
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Gauchotte E, De La Torre M, Perdriolle-Galet E, Lamy C, Gauchotte G, Morel O. Impact of uterine balloon tamponade on the use of invasive procedures in severe postpartum hemorrhage. Acta Obstet Gynecol Scand 2017; 96:877-882. [DOI: 10.1111/aogs.13130] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 03/02/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Emilie Gauchotte
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
| | - Manuela De La Torre
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
- University of Lorraine; Vandœuvre-lès-Nancy France
| | - Estelle Perdriolle-Galet
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
| | - Catherine Lamy
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
| | | | - Olivier Morel
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
- University of Lorraine; Vandœuvre-lès-Nancy France
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Aderoba AK, Olagbuji BN, Akintan AL, Oyeneyin OL, Owa OO, Osaikhuwuomwan JA. Condom-catheter tamponade for the treatment of postpartum haemorrhage and factors associated with success: a prospective observational study. BJOG 2016; 124:1764-1771. [DOI: 10.1111/1471-0528.14361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2016] [Indexed: 11/26/2022]
Affiliation(s)
- AK Aderoba
- Department of Obstetrics and Gynaecology; Mother and Child Hospital; Akure Ondo State Nigeria
| | - BN Olagbuji
- Department of Obstetrics and Gynaecology; Mother and Child Hospital; Akure Ondo State Nigeria
- Department of Obstetrics and Gynaecology; Ekiti State University; Ado-Ekiti Ekiti State Nigeria
| | - AL Akintan
- Department of Obstetrics and Gynaecology; Mother and Child Hospital; Akure Ondo State Nigeria
| | - OL Oyeneyin
- Department of Obstetrics and Gynaecology; Mother and Child Hospital; Ondo Ondo State Nigeria
| | - OO Owa
- Department of Obstetrics and Gynaecology; Mother and Child Hospital; Akure Ondo State Nigeria
| | - JA Osaikhuwuomwan
- Department of Obstetrics and Gynaecology; University of Benin; Benin City Edo State Nigeria
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15
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Matsubara S. Bakri balloon vs. B-Lynch suture as hemostatic procedures for atonic bleeding: clarification and concerns. Arch Gynecol Obstet 2016; 293:1147-8. [DOI: 10.1007/s00404-016-4056-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
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Camuzcuoglu A, Vural M, Hilali NG, Incebiyik A, Yuce HH, Kucuk A, Camuzcuoglu H. Surgical management of 58 patients with placenta praevia percreta. Wien Klin Wochenschr 2016; 128:360-6. [PMID: 26913862 DOI: 10.1007/s00508-016-0962-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 01/21/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study is to present our experience with surgical management of placenta praevia percreta. METHODS This study was conducted from January 2009 through March 2014 at Harran University Hospital and was a chart review of all patients who underwent caesarean hysterectomy with the placenta left in situ for placenta praevia percreta. RESULTS The study group comprised 58 patients. All of the patients underwent ultrasound mapping of the placental area before surgery. Emergent caesarean hysterectomy was only performed in 9 patients; 49 patients underwent planned caesarean hysterectomy. Bilateral internal iliac artery ligation was performed in all cases. Four patients (6.9 %) had bladder damage, one patient (1.7 %) required cystotomy, and one patient (1.7 %) required re-operation because of postoperative hemorrhage. The mean operative time was 141.6 (range: 95-355) minutes. Only 17 (29.3 %) patients were administered more than four units of red blood cells. There was no ureteral damage or maternal death. Furthermore, there were no complications in 42 (72.4 %) patients. CONCLUSIONS Caesarean hysterectomy for placenta praevia percreta is associated with increased maternal morbidity. However, preoperative diagnosis of placenta praevia percreta, ultrasound mapping of the placenta, and the presence of a multidisciplinary experienced team may decrease maternal morbidity and mortality. Moreover, the urinary system may be protected in the patients with placenta praevia percreta without serious morbidity.
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Affiliation(s)
- Aysun Camuzcuoglu
- Department of Obstetrics & Gynaecology, School of Medicine, Mugla Sitki Kocman University, 48000, Mugla, Turkey.
| | - Mehmet Vural
- Department of Obstetrics & Gynaecology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nese Gul Hilali
- Department of Obstetrics & Gynaecology, Harran University, Sanliurfa, Turkey
| | - Adnan Incebiyik
- Department of Obstetrics & Gynaecology, Harran University, Sanliurfa, Turkey
| | - Hasan Husnu Yuce
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Ahmet Kucuk
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Hakan Camuzcuoglu
- Department of Obstetrics & Gynaecology, School of Medicine, Mugla Sitki Kocman University, 48000, Mugla, Turkey
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Efficacy of Bakri Balloon Tamponade in Massive Postpartum Hemorrhage: A Series of 57 Cases. ACTA ACUST UNITED AC 2016. [DOI: 10.14734/pn.2016.27.4.236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Burke TF, Ahn R, Nelson BD, Hines R, Kamara J, Oguttu M, Dulo L, Achieng E, Achieng B, Natarajan A, Maua J, Kargbo S, Altawil Z, Tester K, de Redon E, Niang M, Abdalla K, Eckardt MJ. A postpartum haemorrhage package with condom uterine balloon tamponade: a prospective multi-centre case series in Kenya, Sierra Leone, Senegal, and Nepal. BJOG 2015. [PMID: 26223284 DOI: 10.1111/1471-0528.13550] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effectiveness and safety of an ultra-low-cost uterine balloon tamponade package (ESM-UBT™) for facility-based management of uncontrolled postpartum haemorrhage (PPH) in Kenya, Sierra Leone, Senegal, and Nepal. DESIGN Prospective multi-centre case series. SETTING Facilities in resource-scarce areas of Kenya, Sierra Leone, Nepal, and Senegal. POPULATION Women with uncontrolled postpartum haemorrhage in 307 facilities across the four countries. METHODS A standardised ESM-UBT package was implemented in 307 facilities over 29 months (1 September 2012 to 1 February 2015). Data were collected via a multi-pronged approach including data card completion, chart reviews, and provider interviews. Beginning in August 2014, women who had previously undergone UBT placement were sought and queried regarding potential complications associated with UBT use. MAIN OUTCOME MEASURES All-cause survival, survival from PPH, and post-UBT use complications (surgery, hospitalisation, antibiotics for pelvic infection) associated with UBT use. RESULTS 201 UBTs were placed for uncontrolled vaginal haemorrhage refractory to all other interventions. In all, 38% (71/188) of women were either unconscious or confused at the time of UBT insertion. All-cause survival was 95% (190/201). However, 98% (160/163) of women survived uncontrolled PPH if delivery occurred at an ESM-UBT online facility. One (1/151) potential UBT-associated complication (postpartum endometritis) was identified and two improvised UBTs were placed in women with a ruptured uterus. CONCLUSIONS These pilot data suggest that the ESM-UBT package is a clinically promising and safe method to arrest uncontrolled postpartum haemorrhage and save women's lives. The UBT was successfully placed by all levels of facility-based providers. Future studies are needed to further evaluate the effectiveness of ESM-UBT in low-resource settings. TWEETABLE ABSTRACT Evidence for ESM-UBT as a clinically promising and safe method to arrest uncontrolled PPH and save women's lives.
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Affiliation(s)
- T F Burke
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - R Ahn
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - B D Nelson
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - R Hines
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - J Kamara
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - M Oguttu
- Kisumu Medical and Education Trust, Kisumu, Kenya
| | - L Dulo
- Kisumu Medical and Education Trust, Kisumu, Kenya
| | - E Achieng
- Kisumu Medical and Education Trust, Kisumu, Kenya
| | - B Achieng
- Kisumu Medical and Education Trust, Kisumu, Kenya
| | - A Natarajan
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - J Maua
- Division of Reproductive and Maternal Health, Ministry of Health, Nairobi, Kenya
| | - Sas Kargbo
- Division of Reproductive Health, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Z Altawil
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - K Tester
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - E de Redon
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - M Niang
- Centre de Formation et de Recherche en Santé de la Reproduction, Dakar, Senegal
| | | | - M J Eckardt
- Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.,Department of Obstetrics and Gynecology, Boston Medical Center, Boston, MA, USA
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