title: Balloon tamponade during cesarean section is useful for severe post-partum hemorrhage due to placenta previa.
abstract: OBJECTIVE
  Severe post-partum hemorrhage during cesarean section due to placenta previa is still one of the leading causes of maternal mortality. The aim of this study was to evaluate the efficiency of intrauterine tamponade with a Sengstaken-Blakemore tube (SB-tube) for the treatment of severe post-partum hemorrhage in cases of placenta previa.
  
  
  METHODS
  Data were collected from our departmental clinical records on all patients who underwent caesarian section due to placenta previa between 2007 and 2009.
  
  
  RESULTS
  During the period analyzed, 37 patients underwent caesarian section due to placenta previa/low-lying placenta. Four (11%) underwent hysterectomy due to placenta accreta and 33 (89%) were treated conservatively. Of the 33 patients with conserved uterus, 10 (28%) patients required a SB-tube during the cesarean section because of continuous post-partum hemorrhage despite appropriate medical treatment. The median bleeding during the operation was 2030±860mL in the patients who used SB-tube. None of them presented severe complications related to these procedures or required any further invasive surgery.
  
  
  CONCLUSIONS
  Intrauterine balloon-tamponade could successfully control severe hemorrhage from a lower uterine segment of a patient with placenta previa. This technique is simple to use, scarcely invasive, and available at a low cost to all maternity wards, and should be considered as one of the first management options to reduce the risk of undesirable hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Ishii
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Sawada
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Koyama
authors.forename: Aki
authors.initials: A
authors.lastname: Isobe
authors.forename: Atsuko
authors.initials: A
authors.lastname: Wakabayashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takiuchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kanagawa
authors.forename: Takuji
authors.initials: T
authors.lastname: Tomimatsu
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Ogita
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010923:Placenta Previa / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D058738:Uterine Balloon Tamponade / Q000379:methods*; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy*