Bakri balloon in vaginal-perineal hematomas complicating vaginal delivery: a new therapeutic approach.
OBJECTIVE
The study aimed to evaluate the effectiveness of Bakri balloon as a hemostatic device in severe postpartum hemorrhage due to complicated vaginal-perineal hematoma not responsive to standard surgical treatments.


METHODS
The article discusses an effective and minimally invasive technique for resolving a case of massive vaginal-perineal bleeding after vaginal delivery complicated by ischiorectal fossa hematoma. A 36-year-old primipara white woman, 41 weeks 1 day pregnant, was admitted to our unit for beginning of labor. She experienced a precipitous delivery of a healthy male baby (3.72 kg, 51 cm in length), and spontaneous complete afterbirth of placenta and membranes. The intervention involved positioning of an hemostatic Bakri balloon device in the vagina, to compress the vaginal wall, ensuring that the draining apex was well positioned into the uterine cervix.


RESULTS
The patient was discharged after having a puerperal course without further complications.


CONCLUSIONS
Vaginal hemostatic Bakri balloon device shows hemostatic efficacy immediately assessable, is promptly removable, not interfering with subsequent surgical or radiological procedures, does not increase the risk of infections as other compressive procedures, allows flow of lochia, does not cause pain or discomfort in women, and permits adjustable compression when a drainage is placed during surgery. Despite the high cost, it does not show disadvantages.
Department of Woman and Child Health, University of Padua, Padua, Italy. ginecologia_padova@libero.it
Salvatore
S
Gizzo
Carlo
C
Saccardi
Tito Silvio
TS
Patrelli
Stefania
S
Di Gangi
Donato
D
D'Antona
Giovanni
G
Battista Nardelli
D000328:Adult; D021721:Balloon Occlusion / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D016896:Treatment Outcome