Efficacy of Uterovaginal Packing Versus Uterine Balloon Tamponade to Control Postpartum Hemorrhage Due to Uterine Atony
DOI:
https://doi.org/10.37762/jgmds.10-2.373Keywords:
Postpartum hemorrhage (PPH), Uterine Balloon tamponade (UBT), Uterovaginal packing (UVP), Uterine atony, EfficacyAbstract
OBJECTIVES
To determine and compare the efficacy of Uterovaginal packing versus uterine balloon tamponade to control postpartum haemorrhage due to uterine atony unresponsive to medical treatment.
METHODOLOGY
This comparative prospective cross-sectional study was conducted in Hayatabad Medical Complex, OBG department. A total of 140 patients were categorised into two groups, group A underwent Uterovaginal packing and group B underwent uterine balloon tamponade. All women of 18 to 40 years with a history of delivery after 28 weeks of gestation, who developed primary postpartum haemorrhage due to uterine atony, unresponsive to medical treatment were included in the study. Women with a history of delivery before 28 weeks of gestation, secondary postpartum haemorrhage, genital tract trauma, retained placental tissue and membranes, placenta previa, morbidly adherent placenta, febrile illness and uterine structural lesion were excluded from the study. Efficacy was labelled if there was no ongoing blood loss after the procedure with concomitant hemodynamic stability. All information was recorded in a predesigned proforma, and data were analysed using SPSS version 22.
RESULTS
Our study included 140 women; 113 had a normal vaginal delivery, and 27 underwent cesarean section. Among cases with normal vaginal delivery, 45 women had Uterovaginal packing, and 68 had uterine balloon tamponade, while among cases of cesarean sections, 25 women had uterovaginal packing and 2 had uterine balloon tamponade. The efficacy of Uterovaginal packing was 90%, and that of uterine balloon tamponade was 87.1%, with no significant difference statistically (p- 0.51). Overall efficacy of both procedures was 88.6%.
CONCLUSION
All orthodontic and non-orthodontic treatment group participants required oral hygiene instructions and had periodontal treatment needs (TN1). The patients requiring scaling and prophylaxis and Oral hygiene instructions (TN 2) were more in the orthodontic treatment group than the non-orthodontic treatment group. A higher percentage of patients requiring complex treatment (deep scaling, root planning and complex surgical procedures), scaling and prophylaxis and Oral hygiene instructions (TN3) belonged to the non-orthodontic treatment group.
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Pradhan B, Laxmi RC, Sharma P, Sing A. Uterovaginal packing as treatment in primary Postpartum Hemorrhage in Patan hospital. Nep J Obstet Gynecol .2016;11(1): 44-6
Kishwar N, Rauf B.Effectiveness of uterovaginal packing in the management of primary Postpartum Hemorrhage.J postgrad med inst .2022;36(2):95-103
Naeem S, Parveen F, Najam H, Memon A. Intrauterine balloon tamponade versus intrauterine packing for treatment of Postpartum Hemorrhage. J Liaqat uni med health sci.2021;1-11
Gadre S, Patel S, Gadre A; An overview of women with Postpartum Hemorrhage in a tertiary care center at capital of Madhya pardesh, India. Int J Reprod contracept obstet gynecol .2016;5:23-8
Ashraf N, Ashraf A, Khursheed K; Efficacy and safety of intrauterine balloon tamponade versus uterovaginal roll gauze packing in patients presenting with primary Postpartum Hemorrhage after normal vaginal delivery. Annals king Edw Med uni .2018;24(s):889-92
Kerr R, Eckert LO, Wini Koff B, Durocher J, Meher S; Fawcus S et al; Postpartum hemorrhage: Case definition and guidelines for data collection, analysis and presentation of immunisation safely data.vaccine.2016; 34(49):6102-6
Edwards HM. Aetiology and treatment of severe postpartum Hemorrhage. Dan M.ed J. 2018 Mar; 65(3):B5444
Qadri M, Amir S; to determine the efficacy of uterine packing in management of primary Postpartum Hemorrhage. JSMC. 2017; 7(2):79-82
Sabir SA, Sultan S. The rate of success in Uterovaginal packing in atonic uterus in the Tertiary care hospital in low resource settings. J Med Science. 2021 July;29(3):96-98
Miller HE,Ansari JR. Uterine atony. Curr opine Obstet Gynecol. 2022 Apr 1; 34(2):82-89
Herrick T, Mvundura M, Burke TF, Abu-Hyder E. A low cost uterine balloon tamponade for management of Postpartum Hemorrhage: Modeling the potential impact on maternal mortality and morbidity in sub saharan Africa. BMC pregnancy and childbirth.2017;17(1):374
Wei J, Dai Y wang Z, Gu N, Ju H, Xu Y, Xu B, Hu Y: Iintrauterine double balloon tamponade vs guaze packing in the management of placenta previa: A multicentre randomised control trial. Medicine (Baltimore). 2020 Feb; 99(7):1-7
Makin J, Suarez-Rebling DI, Varma Shiv kumar P, Tarimo V, Burke TF. Innovative use of condom uterine balloon tamponade for Postpartum Hemorrhage in India and Tanzania. Case Rep Obstet Gynecol .2018 June 3;2018:4952048
ALKreedees N, Asiri M.Uterine packing in the management of postpartum hemorrhage: A mini-Review Articles. Am J Pharmacol There. 2021 Jan 27;5(1):001-002
Gupta M, Mitesh J. Role of condom catheter balloon tamponade in management of Atonic postpartum hemorrhage in cases of failed medical management. Int J Clin Obstet Gynaecol. 2017;1(2):62-64
Dr. Jain R. Role of uterine packing in control of Postpartum Hemorrhage in modern obstetrics: JMSCR .2018;6(8):184-9
Javed L, Munir SI, Eusaph AZ. Effectiveness of uterovaginal packing in management of primary Postpartum Hemorrhage. Annal king Edw Medi univ .2017;23(1):58-62
Suarez S, Conde-Agude lo A, Borovac-pin heiro A, Suarez-Rebling D, Eckardt M, Theron G. Uterine balloon tamponade for the treatment of Postpartum Hemorrhage: A systematic review and meta analysis. AM J Obstet Gynecol. 2020;222(4):293
Akhtar KT, Tabbasum S, Siddique S. Efficacy of balloon tamponade in control of primary Postpartum Hemorrhage. Professional Med J .2020;27(4):717-720
Maher MA, Abdul Aziz A, Comparison between two management protocols for postpartum hemorrhage during cesarean section in placenta previa balloon protocol vs non balloon protocol. J Obstet Gynecol Res.2017;43(3):447-55
Pala S, Atilgan R, Baspinar M, Kavak, Yavuzkir S. Akyol A. Comparison of results of Bakri balloon tamponade and cesarean hysterectomy in management of placenta accrete and increta: A retrospective study. J Obstet Gynecol.2018;38(8):1186
Gauchotte E, Torre M. Impact of uterine balloon tamponade on the use of invasive procedure in severe Postpartum Hemorrhage. Acta Obstet Gynecol scand .2017;96(7):877-822
n S.D., Lyubchich A.S., Lyubchich N.I. Efficacy of using controlled uterine balloon tamponade for stopping atonic postpartum hemorrhage // Journal of obstetrics and women’s diseases. - 2022. - Vol. 71. - N. 1. - P. 5-10.
Lohano R, Haq G, Kazi S, Sheikh S. Intrauterine balloon tamponade for the control of Postpartum Hemorrhage. J Pak Med Assoc.2016;66(1):22-6
Rezk M, Saleh S, Shaheen A, Fakhry T. Uterine packing versus foley’s catheter for the treatment of postpartum hemorrhage secondary to bleeding tendency in low-resource setting: A four-year observational study. J Matern Fetal Neonatal Med. 2017 Nov;30(22):2747-2751
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Copyright (c) 2023 Nasreen Kishwar, Rubina Akhter, Shazia Tabassum, Rukhsana Karim, Rabeea Sadaf, Samreen
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