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Article Type

Original Study

Abstract

Objective The aim of this study was to evaluate the outcome of uterine balloon tamponade using a condom-catheter in the management of primary postpartum hemorrhage (PPH). Background Guidelines for the management of postpartum hemorrhage involve a stepwise approach including the exclusion of retained products and genital tract trauma. Uterine atony, which is the most common cause, is dealt with uterine rubbing and various uterotonic agents. Among the new modalities introduced to arrest the bleeding is the uterine tamponade using various balloons and catheters. The condom catheter uses a sterile rubber catheter fitted with a condom that can be used for uterine tamponade. Materials and methods This prospective observational study included 50 women with PPH unresponsive to uterotonics and bimanual compression, and was conducted at the Department of Obstetrics and Gynecology, Menoufia University Hospital, Egypt. About 28 patients suffered from atonic postpartum hemorrhage, whereas 22 patients suffered from PPH due to placenta previa. Clinical assessment, laboratory investigations, and intrauterine condom catheter were applied to all patients. The primary outcome was the success of the balloon to stop bleeding; however, maternal complications were assessed as the secondary outcome. Results The condom catheter was successful in controlling PPH in all cases of atonic PPH (28/28; 100%): 18 after vaginal delivery and 10 after cesarean section. It successfully controlled PPH due to placental site bleeding in 20 cases (90%) and failed to control PPH in two cases (10%), which were managed by cesarean hysterectomy. There was (P<0.001) a significant statistical difference between vaginal and abdominal balloon insertion regarding postinsertion complications. Conclusion The condom catheter controls PPH effectively. It is a simple, inexpensive, and safe method of conserving the reproductive capacity along with saving the life of women with primary PPH.

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