title: [Bakri balloon tamponade for severe post-partum haemorrhage: efficiency and fertility outcomes].
abstract: OBJECTIVE
  To evaluate efficiency of Bakri balloon tamponade (BB) to stop severe post-partum haemorrhage (PPH) and fertility outcomes.
  
  
  METHODS
  Retrospective study including all patients who underwent Bakri balloon tamponade for severe PPH between January 2009 and December 2013. The objectives were to stop PPH by BB and to evaluate the fertility after Bakri balloon tamponade.
  
  
  RESULTS
  Sixty-one women had a Bakri balloon inserted in utero for severe PPH. The PPH was stopped in 55 patients out of 61 (88%). The reasons of severe PPH were uterine atony in 44 cases (72%), placental retention in 10 cases, placenta praevia in 3 cases, and cervical or vaginal tears in 4 cases. In one third of cases, the pregnancy was complicated by diabetes, placenta praevia, hypertensive troubles. A cesarean section or an instrumental delivery was performed for one third of patients. The mean duration of the Bakri balloon insertion was of 7 hours [5-9] and the mean filling of the balloon was of 350 ml [205-450]. The mean blood loss was of 1600 [1200-2250]. Sixty-three percent of patients (n=38) received red blood cells transfusion. The BB was efficient after a vaginal delivery or after a caesarean section and in all cases of placenta praevia. In 6 cases, the BB was inefficient and uterine embolisation or a surgical procedure was performed to stop PPH. Nine women underwent a new pregnancy after the insertion of Bakri balloon for severe PPH and 3 delivered healthy newborns.
  
  
  CONCLUSIONS
  Bakri balloon tamponade is a minimally invasive intrauterine device efficient to stop severe post-partum haemorrhage. New pregnancies and deliveries are possible after tamponade by Bakri balloon.
authors: Département de gynécologie-obstétrique, CHR d'Orléans, 1, Porte-Madeleine, 45000 Orléans, France. Electronic address: alouini.s@orange.fr.
authors: S
authors: S
authors: Alouini
authors: Département de gynécologie-obstétrique, CHR d'Orléans, 1, Porte-Madeleine, 45000 Orléans, France.
authors: L
authors: L
authors: Bedouet
authors: Département de gynécologie-obstétrique, CHR d'Orléans, 1, Porte-Madeleine, 45000 Orléans, France.
authors: A
authors: A
authors: Ramos
authors: Département de gynécologie-obstétrique, CHR d'Orléans, 1, Porte-Madeleine, 45000 Orléans, France.
authors: C
authors: C
authors: Ceccaldi
authors: Département de gynécologie-obstétrique, CHR d'Orléans, 1, Porte-Madeleine, 45000 Orléans, France.
authors: M L
authors: ML
authors: Evrard
authors: Département de radiologie interventionnelle, CHR Orléans-La Source, 45100, France.
authors: K
authors: K
authors: Khadre
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D010298:Parity; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D058738:Uterine Balloon Tamponade / Q000295:instrumentation* / Q000379:methods
keywords: Bakri balloon tamponade; Ballon de Bakri; Fertility after Bakri balloon tamponade; Fertilité après ballon de Bakri; Hémorragie du post-partum; Postpartum haemorrhage