Ahmed Said Ali1, Esraa Faraag2, Maged Mohammed3, Zainab Elmarghany1, Mariam Helaly4, Ahmed Gadallah5, Mohammad A Taymour6, Yahia Ahmad6, Ahmed Ibrahim Eissa7, Asmaa Ibrahim Ogila6, Mohammed K Ali8, Hisham A Abou-Taleb8, Ahmed Samy6, Ahmed M Abbas8. 1. Faculty of Medicine, Al-Azhar University, Cairo, Egypt. 2. Faculty of Medicine, Cairo University, Cairo, Egypt. 3. Faculty of Medicine, Zagazig University, Zagazig, Egypt. 4. Faculty of Pharmacy, Cairo University Clinical Program, Cairo, Egypt. 5. Faculty of Medicine, Ain Shams University, Cairo, Egypt. 6. Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University, Cairo, Egypt. 7. Department of Obstetrics and Gynaecology, Al Hammadi Hospital, Riyadh, Kingdom of Saudi Arabia. 8. Department of Obstetrics and Gynaecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Abstract
Background: Postpartum hemorrhage (PPH) is a direct cause of maternal death all over the world. A Bakri balloon is recommended by American College of Obstetricians and Gynecologists (ACOG) and World Health Organization (WHO) as a treatment line for PPH unresponsive to uterotonics. We carried out a systematic review to assess the safety and effectiveness of Bakri balloon in the management of PPH. Methods: We searched PubMed, SCOPUS, central Cochrane, and Web of Science, from 2001 to 2018 for randomized controlled trials (RCTs) and observational studies to assess the safety and effectiveness of Bakri balloon on refractory PPH. Results: Twenty-eight articles were included for analysis. The primary indication for the use of a Bakri balloon tamponade was PPH. Only 67.9% (19/28) quantified the estimate blood loss necessary to use the balloon. Uterine atony was the underlying cause of PPH in 75% (21/28) of studies. Most of the studies on Bakri balloon are followed by vaginal birth (3/4). Bakri balloon displacement from the uterine cavity was reported by five publications, with the overall rate being 9% (95% CI: 5-15%). Hysterectomy was necessary for 1% (95% CI: 0-8%) of the women who required the balloon.Conclusions: Bakri balloon seems to be a less effective tool for management of PPH either after vaginal or cesarean delivery.
Background: Postpartum hemorrhage (PPH) is a direct cause of maternal death all over the world. A Bakri balloon is recommended by American College of Obstetricians and Gynecologists (ACOG) and World Health Organization (WHO) as a treatment line for PPH unresponsive to uterotonics. We carried out a systematic review to assess the safety and effectiveness of Bakri balloon in the management of PPH. Methods: We searched PubMed, SCOPUS, central Cochrane, and Web of Science, from 2001 to 2018 for randomized controlled trials (RCTs) and observational studies to assess the safety and effectiveness of Bakri balloon on refractory PPH. Results: Twenty-eight articles were included for analysis. The primary indication for the use of a Bakri balloon tamponade was PPH. Only 67.9% (19/28) quantified the estimate blood loss necessary to use the balloon. Uterine atony was the underlying cause of PPH in 75% (21/28) of studies. Most of the studies on Bakri balloon are followed by vaginal birth (3/4). Bakri balloon displacement from the uterine cavity was reported by five publications, with the overall rate being 9% (95% CI: 5-15%). Hysterectomy was necessary for 1% (95% CI: 0-8%) of the women who required the balloon.Conclusions: Bakri balloon seems to be a less effective tool for management of PPH either after vaginal or cesarean delivery.
Authors: V Pingray; M Widmer; A Ciapponi; G J Hofmeyr; C Deneux; M Gülmezoglu; K Bloemenkamp; O T Oladapo; D Comandé; A Bardach; P Vázquez; G Cormick; F Althabe Journal: BJOG Date: 2021-07-19 Impact factor: 7.331