[Obstetric hemorrhage control Bakri balloon].
BACKGROUND
Obstetric hemorrhage is the second leading cause of maternal death in Mexico. Intrauterine tamponades are a valuable resource for the limitation of bleeding.


OBJECTIVE
Analyze the success rate of the Bakri balloon in the control of obstetric hemorrhage and calculate the fill volume with clinical parameters.


METHODS
Descriptive, retrospective and observational study Subjects were included who presented refractory hemorrhage on administration of uterotonics (postpartum, caesarean section, post-caesarean section, and post-miscarriage); a Bakri balloon was inserted with epidural anesthesia. The procedure was considered successful where there was immediate cessation of hemorrhage without recurrence. The fill volume in milliliters (FV) was analyzed with a linear regression that included gestational age in weeks (GA) and neonatal weight in grams (NW).


RESULTS
The study included 35 subjects: 20 postpartum (57.1%), 10 caesarean and post-caesarean section (28.5%), and 5 post-miscarriage (14.2%). Use of the Bakri balloon was successful in 33 cases (94.2%). Unsuccessful cases involved subinvolution of the placental site and placenta accreta. Fill volume correlated with gestational age (r=0.50, p=0.001) and with neonatal weight (r=0.47, p=0.002). The linear regression equation for calculation of the fill volume is FV = 150 + (4.3 x GA) + (0.03 x NW), (p = 0.003).


CONCLUSIONS
Use of the Bakri balloon is safe, simple, and effective; we encountered no adverse reactions in this study. The procedure can be carried out after delivery or miscarriage or during or after a caesarean section.
Departamento de Obstetricia, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, México, DF. draveroortega@yahoo.com
Verónica María de Jesús
VM
Ortega-Castillo
Salvador
S
Espino y Sosa
Tomás
T
Herrerías-Canedo
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D012189:Retrospective Studies; D058738:Uterine Balloon Tamponade / Q000295:instrumentation; D055815:Young Adult