Balloon tamponade for postpartum haemorrhage: case series and literature review.

OBJECTIVES To audit the use of intrauterine balloon tamponade for the management of massive postpartum haemorrhage and compare outcomes with those documented in the literature. DESIGN Retrospective case series. SETTING Obstetric Unit of a regional hospital in Hong Kong. PATIENTS All cases with severe postpartum haemorrhage from January 2011 to June 2012 in which Bakri intrauterine balloon catheters were used for management. MAIN OUTCOME MEASURE Successful management with prevention of hysterectomy. RESULTS A total of 19 cases were identified. The postpartum haemorrhage was successfully treated without the need for additional procedures in 15 patients. Hysterectomy was avoided in a further two cases by recourse to radiologically guided uterine artery embolisation. In two patients, balloon tamponade failed in that hysterectomy was carried out. Thus, the overall success rate of intrauterine balloon tamponade alone was 79%, which was comparable to reported rates in the literature. CONCLUSION Bakri balloon tamponade is an effective means of managing massive postpartum haemorrhage, and should be adopted in protocols to manage such patients.