title: The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage.
abstract: OBJECTIVE
  To evaluate intrauterine balloon tamponade with or without B-Lynch sutures in avoiding postpartum hysterectomy in cases with severe postpartum hemorrhage.
  
  
  METHODS
  Retrospective analysis using all women delivering between January 2005 and July 2010 in our center. Prevention of hysterectomy was the main outcome studied.
  
  
  RESULTS
  Twenty-four cases of severe postpartum hemorrhage occurred in which medical treatment alone failed. In 20 cases, the Bakri balloon was the first choice to stop hemorrhage. Sixty percent (n = 12) of these were successfully treated with the balloon alone, 30% (n = 6) with the balloon and the B-Lynch suture. Therefore, 90% (n = 18) were successfully treated with the balloon as part of the treatment. The balloon tamponade was not successful in 2 cases. Four cases were treated with emergency hysterectomy a priori.
  
  
  CONCLUSIONS
  The Bakri balloon with or without B-Lynch sutures in a stepwise approach is an effective option for the treatment of severe PPH.
authors: Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Germany.
authors: Anke
authors: A
authors: Diemert
authors: Gerhard
authors: G
authors: Ortmeyer
authors: Bettina
authors: B
authors: Hollwitz
authors: Manuela
authors: M
authors: Lotz
authors: Thierry
authors: T
authors: Somville
authors: Peter
authors: P
authors: Glosemeyer
authors: Werner
authors: W
authors: Diehl
authors: Kurt
authors: K
authors: Hecher
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007044:Hysterectomy; D006473:Postpartum Hemorrhage / Q000601:surgery / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery / Q000628:therapy; D012720:Severity of Illness Index; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D058738:Uterine Balloon Tamponade; D055815:Young Adult