Differential Effects of Intrauterine Balloon Tamponade Indications on Postpartum Hemorrhage Outcomes

Frontiers in Medicine

卷:9

Xinliang Chen³  Lin Wen³  Yiyao Chen³  Xiaolei Chi³  Chuangchuang Xu³ 

[1] Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;

[2] Department of Pelvic Floor Clinic Center, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;

[3] Shanghai Key Laboratory of Embryo Original Disease, Shanghai Jiao Tong University, Shanghai, China;

关键词: postpartum hemorrhage;    placental site bleeding;    uterine atony;    intrauterine balloon tamponade;    blood transfusion;    estimated blood loss;   

DOI  :  10.3389/fmed.2022.851174

来源: DOAJ

【 摘 要 】

ObjectiveTo determine whether the indication of intrauterine balloon tamponade (IUBT) was associated with postpartum hemorrhage (PPH) outcomes.MethodsPatients with PPH who underwent IUBT between January 2013 and November 2021 were included in a cohort study. PPH outcomes in patients who had IUBT for indications of uterine atony were compared to those who had IUBT for indications of placental site bleeding. PPH outcomes included uterine artery embolization (UAE) or hysterectomy after IUBT, estimated blood loss (EBL) after balloon placement, and blood transfusion. Statistical analysis was performed using multivariate logistic regression.ResultsIUBT was performed on 603 cases, with 121 (20.1%) undergoing it for placental site bleeding and 482 (79.9%) for uterine atony. In general, IUBT was a reliable treatment for PPH, but the specific efficacy varied depending on the indication for placement. After controlling for confounding variables, compared to the indication of uterine atony, the indication of placental site bleeding increased the risk of transfusion of ≥4 units of PRBCs (aOR 2.47, 95%CI 1.32–3.98), EBL ≥ 300 ml after IUBT (aOR 3.78, 95%CI 2.22–5.33), and UAE or hysterectomy (aOR 2.52, 95%CI 1.20–6.01), respectively. Other factors associated with adverse PPH outcomes were lower antenatal hemoglobin, higher IUBT volume, longer duration of IUBT and larger shock index values.ConclusionsIUBT was less effective in treating PPH patients with indications of placental site bleeding than with indications of uterine atony. Follow-up monitoring of PPH patients with placental site bleeding should be intensified.

【 授权许可】

Unknown