title: Successful use of BT-Cath(®) balloon tamponade in the management of postpartum haemorrhage due to placenta previa.
abstract: OBJECTIVE
  To investigate efficacy of the BT-Cath(®) in cases of uncontrollable haemorrhage due to placenta previa.
  
  
  METHODS
  Retrospective study of women treated with the BT-Cath in the event of postpartum haemorrhage (PPH) due to placenta previa, despite optimal management with medical treatment.
  
  
  RESULTS
  Between 2011 and 2013, 237 women had placenta previa (0.45%) at the study hospital. This study evaluated 53 women who underwent uterine tamponade with a BT-Cath. Haemostasis was achieved in 45 women (85%), and hysterectomy was required in six women (11%). Two women required repeat laparotomy. The mean duration of balloon tamponade was 9.8h (standard deviation 6.4h). When the relationship between balloon volume and treatment success was evaluated, the area under the receiver operating characteristic curve was 0.803 (95% confidence interval 0.633-0.973; p=0.007) and the optimal cut-off point was 220ml, with sensitivity of 88% and specificity of 71%.
  
  
  CONCLUSIONS
  The intra-uterine BT-Cath is simple to use, even among clinicians with little experience, and is an effective treatment choice in patients with PPH due to placenta previa when medical treatment is unsuccessful. Minimal inflation of the balloon, a shorter period of intra-uterine balloon tamponade and early deflation of the balloon are recommended.
authors.affiliation: Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Department of Perinatology, Ankara, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Uygur
authors.affiliation: Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Department of Perinatology, Ankara, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Altun Ensari
authors.affiliation: Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Department of Perinatology, Ankara, Turkey. Electronic address: sevalerdinc@gmail.com.
authors.forename: A S
authors.initials: AS
authors.lastname: Ozgu-Erdinc
authors.affiliation: Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Department of Perinatology, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Dede
authors.affiliation: Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Department of Perinatology, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Erkaya
authors.affiliation: Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Department of Perinatology, Ankara, Turkey.
authors.forename: A N
authors.initials: AN
authors.lastname: Danisman
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010923:Placenta Previa / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D011247:Pregnancy; D012372:ROC Curve; D019233:Retreatment; D012189:Retrospective Studies; D058738:Uterine Balloon Tamponade; D055815:Young Adult
keywords: Balloon tamponade; Placenta previa; Postpartum haemorrhage