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Initial experience with a dual-balloon catheter for the management of postpartum hemorrhage - 25/01/14

Doi : 10.1016/j.ajog.2013.09.015 
Gary A. Dildy, MD a, Michael A. Belfort, MD, PhD a, C. David Adair, MD d, Kimberly Destefano, MD b, Donna Robinson, RNC b, Garrett Lam, MD e, Thomas H. Strong, MD e, Clive Polon, MD c, Robert Massaro, MD f, Jayasri Bukkapatnam, MD g, James W. Van Hook, MD h, Iskander Kassis, MD j, Shiraz Sunderji, MD i
and the

ebb Surveillance Study Team

a Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 
b St. David's Women's Center of Texas, Austin, TX 
c St. David's Medical Center, Austin, TX 
d Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, and Glenveigh Medical, LLC, Chattanooga, TN 
e Banner Good Samaritan Medical Center, Phoenix, AZ 
f Monmouth Medical Center, Long Branch, NJ 
g Orlando Health, Orlando, FL 
h University of Cincinnati, Greater Cincinnati OB/GYN, Cincinnati, OH 
i The Toledo Hospital, Toledo, OH 
j UHS–Wilson Medical Center, Johnson City, NY 

Abstract

Objective

When uterotonics fail to cause sustained uterine contractions and satisfactory control of hemorrhage after delivery, tamponade of the uterus can be effective in decreasing hemorrhage secondary to uterine atony.

Study Design

These data are from a postmarketing surveillance study of a novel dual-balloon catheter tamponade device, the Belfort-Dildy Obstetrical Tamponade System (ebb).

Results

A total of 57 women were enrolled: 55 women had the diagnosis of postpartum hemorrhage, and 51 women had uterine balloon placement within the uterine cavity. This study reports the outcomes in the 51 women who had uterine balloon placement within the uterine cavity for treatment of postpartum hemorrhage, as defined by the “Instructions for Use.” We further assessed 4 subgroups: uterine atony only (n = 28 women), placentation abnormalities (n = 8 women), both uterine atony and placentation abnormalities (n = 9 women), and neither uterine atony nor placentation abnormalities (n = 6 women). The median (range) time interval between delivery and balloon placement was 2.2 hours (0.3–210 hours) for the entire cohort (n = 51 women) and 1.3 hours (0.5–7.0 hours) for the uterine atony only group (n = 28 women). Bleeding decreased in 22/51 of cases (43%), stopped in 28/51 of cases (55%), thus decreased or stopped in 50/51 of the cases (98%) after balloon placement. Nearly one-half (23/51) of all women required uterine balloon volumes of >500 mL to control bleeding.

Conclusion

We conclude that uterine/vaginal balloon tamponade is very useful in the management of postpartum hemorrhage because of uterine atony and abnormal placentation.

Il testo completo di questo articolo è disponibile in PDF.

Key words : abnormal placentation, balloon tamponade, postpartum hemorrhage, uterine atony


Mappa


 The remaining participants in the ebb Surveillance Study Team are listed in the Acknowledgments.
 Supported by Glenveigh Medical.
 G.A.D. and M.A.B. are the inventors and patent holders of the medical device described in this article. C.D.A. is Chairman and CSO of Glenveigh Medical, LLC, and its wholly owned subsidiary, Glenveigh Surgical, LLC (collectively, Glenveigh Medical), which is the manufacturer of the medical device described in this article. The remaining authors report no conflict of interest.
 Reprints not available from the authors.
 Cite this article as: Dildy GA, Belfort MA, Adair CD, et al. Initial experience with a dual-balloon catheter for the management of postpartum hemorrhage. Am J Obstet Gynecol 2014;210:136.e1-6.


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Vol 210 - N° 2

P. 136.e1-136.e6 - febbraio 2014 Ritorno al numero
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