Comparison of Efficacy and Safety of Intrauterine Balloon Tamponade Versus Uterovaginal Packing in Females Presenting with Postpartum Hemorrhage after Normal Vaginal Delivery

Subhadra Agrawal, Shamila Ijaj Munir
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Abstract

To compare the efficacy and safety of intrauterine balloon tamponade with uterovaginal roll gauze packing in patients presenting with primary postpartum hemorrhage after normal vaginal delivery. This randomized controlled trial, conducted at Department of Obstetrics and Gynecology, Lady Willingdon Hospital, Lahore, from December 2015 to November 2016. Two hundred and twelve patients presenting with primary postpartum hemorrhage who did not respond to medical treatment following normal vaginal delivery were included. They were randomly divided in two groups. The first group underwent balloon tamponade using condom and second group underwent intrauterine packing using roll gauze. Both interventions were removed after 24 hours. All females were kept under observation with antibiotic coverage in ward to prevent infection. If bleeding was stopped within 15 minutes and the patient remained hemodynamically stable, then efficacy was labeled and if no complications occur while applying or removing, safety was labeled. Mean age group of women using balloon tamponade and intrauterine packing was used was 28.25±4.672 and 28.30±4.613 years. The mean gestational age of patients using balloon tamponade and intrauterine packing was 38.57±1.36 and 38.63±0.62 years. Mean blood loss in patients using balloon tamponade and intrauterine packing was 600.28±25.338 and 699.21±70.176 ml. Efficacy of intrauterine packing was 94 (88.7%) and balloon tamponade was 104 (98.1%). Safety of intrauterine packing was 83 (78.3%) and that of balloon tamponade was 97 (91.5%). Thus, treatment of balloon tamponade was more effective and safer than intrauterine packing in female presenting with postpartum hemorrhage after normal vaginal delivery.
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宫腔内球囊填塞与子宫阴道填塞对阴道正常分娩后出现产后出血的女性的有效性和安全性比较
目的:比较宫腔内球囊填塞与子宫阴道卷纱布填塞对阴道正常分娩后出现原发性产后出血患者的疗效和安全性。这项随机对照试验于 2015 年 12 月至 2016 年 11 月在拉合尔威灵顿夫人医院妇产科进行。试验纳入了 212 名经阴道正常分娩后对药物治疗无效的原发性产后出血患者。他们被随机分为两组。第一组使用安全套进行球囊填塞,第二组使用卷纱布进行宫腔填塞。两种干预措施均在 24 小时后去除。为防止感染,所有女性均在病房接受抗生素治疗。如果出血在 15 分钟内停止,且患者血流动力学保持稳定,则判定为有效;如果在使用或取出时未发生并发症,则判定为安全。使用球囊填塞和宫内填塞的妇女平均年龄分别为(28.25±4.672)岁和(28.30±4.613)岁。使用球囊填塞和宫内填塞的患者的平均孕龄分别为(38.57±1.36)岁和(38.63±0.62)岁。使用球囊填塞和宫腔填塞的患者的平均失血量分别为(600.28±25.338)毫升和(699.21±70.176)毫升。宫腔填塞的有效率为 94(88.7%),球囊填塞的有效率为 104(98.1%)。宫腔填塞的安全性为 83(78.3%),球囊填塞的安全性为 97(91.5%)。因此,对于经阴道正常分娩后出现产后出血的女性,球囊填塞比宫腔内填塞更有效、更安全。
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