title: Use of an intrauterine inflated catheter balloon in massive post-partum hemorrhage: a series of 52 cases.
abstract: OBJECTIVE
  Massive post-partum hemorrhage (PPH) is an important cause of maternal death that occurs as a complication of delivery. We report a large case series to evaluate the efficacy of uterine balloon tamponade to treat PPH avoiding hysterectomy.
  
  
  METHODS
  This prospective study was conducted in two Italian hospitals (from December 2002 to July 2012). Fifty-two patients with PPH not responsive to uterotonics were treated by Rusch balloon. A follow-up was conducted among the study population to assess the subsequent fertility.
  
  
  RESULTS
  The most frequent cause of PPH was atony (59.6%), followed by placenta previa (21.2%), placenta accreta (9.6%), and placenta previa and accreta (9.6%). The balloon success rate to control hemorrhage was 75%. From the sample of 52 patients, 13 patients needed additional procedures. In three failure cases, other conservative techniques were used and the overall effectiveness of them was 80.7%. The follow-up group consisted of 31 women. Of these women, 24 women (77.4%) had no further pregnancies, but only one due to sterility. Four of seven patients with subsequent pregnancies made it to term without complications.
  
  
  CONCLUSIONS
  The Rusch balloon is effective in controlling non-traumatic PPH in 75% of cases. It is simple to use, readily available and cheap. If necessary, this technique does not exclude other procedures. We suggest that this balloon should be included routinely in the PPH protocol.
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart.
authors.forename: Sergio
authors.initials: S
authors.lastname: Ferrazzani
authors.forename: Roberta
authors.initials: R
authors.lastname: Iadarola
authors.forename: Alessandra
authors.initials: A
authors.lastname: Perrelli
authors.forename: Angela
authors.initials: A
authors.lastname: Botta
authors.forename: Sascia
authors.initials: S
authors.lastname: Moresi
authors.forename: Silvia
authors.initials: S
authors.lastname: Salvi
authors.forename: Stefania
authors.initials: S
authors.lastname: Santucci
authors.forename: Valentina Anna
authors.initials: VA
authors.lastname: Degennaro
authors.forename: Sara
authors.initials: S
authors.lastname: De Carolis
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D058738:Uterine Balloon Tamponade
keywords: balloon tamponade; placenta accreta; placenta previa; post-partum hemorrhage; uterine atony