Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 6 ( November-December, 2022 ) > List of Articles

Original Article

Efficacy of Intrauterine Balloon Tamponade by 24-French Foley Catheter in Prevention of Postpartum Hemorrhage

Keywords : Atonic postpartum hemorrhage, Intrauterine balloon tamponade, 24-French Foley catheter, Foley catheter in postpartum hemorrhage

Citation Information : Efficacy of Intrauterine Balloon Tamponade by 24-French Foley Catheter in Prevention of Postpartum Hemorrhage. J South Asian Feder Obs Gynae 2022; 14 (6):649-652.

DOI: 10.5005/jp-journals-10006-2139

License: CC BY-NC 4.0

Published Online: 31-01-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Background: Postpartum hemorrhage (PPH), is one of the most common causes of maternal mortality as well as morbidity worldwide. Around 88% of maternal deaths occur in the first 4 hours of delivery. So, the majority is the consequence of events in the third stage of labor. Most cases of primary PPH are caused by atonic uterus often due to prolonged labor, pre-eclampsia, or past history of PPH. Management of PPH involves a stepwise approach from medical to surgical management like laparotomy for systemic devascularization, uterine compression sutures, or peripartum hysterectomy. In 1983, Goldrath published that uterine tamponade can be possible by insufflating a Foley catheter in the uterus. Commercially available catheters such as Sengstaken Blackmore tube, Rusch urological catheter, and Bakri balloon are commonly used; however, their cost is the limiting factor for the regions of less privilege. Hence, this study is planned to evaluate the efficacy of 24-French Foley catheter tamponade in atonic PPH, after the failure of medical management, which is easily available, economical, and also quantifies blood loss. Methods: It is a prospective study. The subjects were PPH patients who failed to respond to medical management and were hemodynamically stable. Intrauterine 24-French Foley catheter was applied. The vital parameters were monitored. Monitoring for vaginal bleeding was done. The Foley catheter was kept for 24 hours. Results: Atonic PPH was there in 961 subjects. Intrauterine balloon tamponade by 24-French Foley catheter was applied to 800 patients. The duration of the study was June 2014 to May 2020 in Gadag Institute of Medical Sciences, Gadag, Karnataka. It was effective in 766 (95.75%) subjects. Around 34 subjects were in need of surgical management. Hence this alternative simple intervention method decreased many surgical interventions and respective morbidity. Conclusions: The intrauterine balloon tamponade by 24-French Foley catheter is the most effective, quite simple economical technique for preventing blood loss in atonic PPH.

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  1. World Health Organization. Trends in maternal mortality: 1990–2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Executive summary. Available at: Accessed date: 16 March 2021.
  2. Carroli G, Cuesta C, Abalos E, et al. Epidemiology of postpartum hemorrhage: A systematic review. Best Practice Res Clin Obstet Gynaecol 2008;22(6):999–1012. DOI: 10.1016/j.bpobgyn.2008.08.004.
  3. Society of Obstetricians and Gynaecologists of Canada. Advances in labor and risk management (ALARM) course manual, 9th ed. Ottawa, Ontario: Society of Obstetricians and Gynaecologists of Canada, 2002;389–390.
  4. Weeks A. The prevention and treatment of postpartum haemorrhage: What do we know, and where do we go to next? BJOG 2015; 122(2):202–210. DOI: 10.1111/1471-0528.13098.
  5. Goldrath MH. Uterine tamponade for the control of acute uterine bleeding. Am J Obstet Gynecol 1983;147:869–872. DOI: 10.016/0002-9378(83)90237-5.
  6. Condous GS, Arulkumaran S, Symonds I, et al. The “tamponade test” in the management of massive postpartum hemorrhage. Obstet Gynecol 2003;101(4):767–772. DOI: 10.1016/s0029-7844(03)00046-2.
  7. Doumouchtsis SK, Papageorghiou AT, Arulkumaran S. Systematic review of conservative management of postpartum hemorrhage: What to do when medical treatment fails. Obstet Gynecol Surv 2007;62(8):540–547. DOI: 10.1097/01.ogx.0000271137.81361.93.
  8. Rathore AM, Gupta S, Manaktala U, et al. Uterine tamponade using condom catheter balloon in the management of non-traumatic postpartum hemorrhage. J Obstet Gynaecol Res 2012;38(9):1162–1167. DOI: 10.1111/j.1447-0756.2011.01843.x.
  9. Kandeel M, Sanad Z, Ellakwa HE, et al. Management of postpartum hemorrhage with intrauterine balloon tamponade using a condom catheter in an Egyptian setting. Int J Gynaecol Obstet 2016;135(3):272–275. DOI:10.1016/j.ijgo.2016.06.018.
  10. World Health Organization, UNICEF, UNFPA, et al. Trends in maternal mortality: 1990 to 2008: Estimates Developed by WHO, UNICEF, UNFPA and The World Bank. 2010. Accessed date: 16 March 2021.
  11. B-Lynch C. Conservative surgical management. A Text Book of Postpartum Hemmorhage, 1st edition. UK: Sapiens; 2006, pp. 287–298.
  12. Al-Zirqi I, Vangen S, Forsen L, et al. Prevalence and risk factors of severe obstetric haemorrhage. BJOG 2008;115(10):1265–1272. DOI: 10.1111/j.1471-0528.2008.01859.x.
  13. Gai MY, Wu LF, Su QF, et al. Clinical observation of blood loss reduced by tranexamic acid during and after caesarian section: A multi-center, randomized trial. Eu J Obstet Gynecol Reprod Biol 2004;112(2):154–157. DOI: 10.1016/s0301-2115(03)00287-2.
  14. Bhavana G, Abhishek MV, Mittal S. A study of risk factors of postpartum hemorrhage and indications for caesarean section. Int J Reprod Contracept Obstet Gynecol 2017;5(6):2017–2021. DOI: 10.18203/2320-1770.ijrcog20161709.
  15. Knight M. Peripartum hysterectomy in the UK: Management and outcomes of the associated haemorrhage. BJOG 2007;114(11):1380–1387. DOI: 10.1111/j.1471-0528.2007.01507.x.
  16. Nahar N, Yusuf N, Ashraf F. Role of intrauterine balloon catheter in controlling massive PPH: Experience in Rajshahi Medical College Hospital. Orion Med J 2009;2:682–683.
  17. Tirumuru S, Saba S, Morsi H, et al. Intrauterine balloon tamponade in the management of severe postpartum hemorrhage: A case series from a busy UK district general hospital. OJOG 2013;3:131–136. DOI: 10.4236/ojog.2013.31A025.
  18. Garg R, Agarwal V, Singh S, et al. Role of condom catheter in managing postpartum hemorrhage in developing country, India. Indian Obstet Gynaecol 2018;8(3):8–10.
  19. Garg R, Yadav A. Condom balloon tamponade for postpartum hemorrhage in developing countries: Cost-effective boon for saving mothers. J South Asian Feder Obs Gynae 2022;14(2):189–191. DOI: 10.5005/jp-journals-10006-2028.
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