Background: Postpartum hemorrhage (PPH) remains the most common form of major obstetric hemorrhage and is also the leading cause of maternal morbidity as well as mortality. With the use of effective modalities and interventions to prevent and treat PPH, we can definitely reduce the burden of this life-threatening condition. In cases of PPH not responding to the medical line of management, second-line interventions like balloon tamponade, devascularization, compression sutures, and hysterectomy as the final resort can be thought of.
Aims and objectives: The aim of this study is to determine the effectiveness of ESM-uterine balloon tamponade (UBT) in cases of PPH not responding to the medical line of management.
Materials and methods: In this prospective case–control study, 26 cases with PPH refractory to the medical line of management in whom UBT was placed were studied. Data were collected over a period of 1 year and analyzed.
Result: The total number of deliveries including vaginal as well as the cesarean section was 1,359 out of which 26 patients had PPH not responding to the medical line of management, thus contributing 1.9% incidence of refractory PPH in this study. The mean age of the study population was 28.4 ± 2.3 years, and the blood loss ranged from 800 to 3000 mL. The success rate of ESM-UBT alone was 85%, and if combined with additional interventions like stepwise devascularization and compression sutures, it increased to 96.15%. One patient required a peripartum hysterectomy in spite of all measures, so the failure rate was 3.85%. No maternal death was recorded in this study.
Conclusion: ESM-UBT is an innovative approach in the management of the PPH not responding to medical management. Our study recommends using ESM-UBT in cases of PPH with failed medical management before directly proceeding with surgical interventions.
Clinical significance: ESM-UBT is an inexpensive, cost-effective, easy-to-use, easily available, affordable, and effective tool to manage PPH not responding to medical management, and thus will definitely help to reduce related maternal mortality and morbidity.
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