What is the Optimal Duration of Intrauterine Balloon Tamponade?
This study by Einerson et al. (AJOG, 2017) sought to determine if there is a difference in clinical outcomes between removing the intrauterine balloon tamponade after >12 hours or between 2-12 hours.
Retrospective Cohort Study
274 women with postpartum hemorrhage who underwent intrauterine balloon tamponade were included in the study. 206 (75%) women had the intrauterine balloon tamponade removed after more than 12 hours, and 86 (25%) women underwent intrauterine balloon tamponade for 2-12 hours. There was no statistically significant difference between median estimated blood loss after intrauterine balloon tamponade placement (190 ml vs. 143 ml; P=.116), frequencies of blood product transfusion (62.1% vs. 51.5%; P=.120), transfusion of ≥4 U of packed red blood cells (17.0% vs. 14.7%; P=.659), uterine artery embolization (15.1% vs. 16.2%; P=.823), hysterectomy (0.0% vs. 1.5%; P=.248), and ICU admission (8.7% vs. 7.4%; P=721). However, duration of longer than 12 hours was associated with a higher frequency of postpartum fever (27% vs. 15%; P=.047). Increased infection rate remained even after adjusting for possible confounding variables between the two groups. The authors suggest that if bleeding is under good control, consideration can be given to removing the balloon at < 12 hours.
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