title: Success factors for Bakri™ balloon usage secondary to uterine atony: a retrospective, multicentre study.
abstract: BACKGROUND
  Post-partum haemorrhage (PPH) is one of the major obstetric complications and remains a cause of avoidable maternal mortality and morbidity.
  
  
  OBJECTIVE
  The aims of this study were to assess the success and practicability of a Bakri™ balloon intrauterine tamponade for PPH and evaluate the predictive factors for success.
  
  
  METHODS
  Women who received the Bakri™ balloon secondary to uterine atony and subsequent failure of routine drug treatment were identified at 6 hospital sites. Demographic, obstetric and specific factors in regard to the Bakri™ balloon use were recorded. Factors predictive of Bakri™ balloon success were evaluated.
  
  
  RESULTS
  Intrauterine Bakri™ balloon tamponade was used in 36 women with uterine atony of which 28 received the balloon treatment after vaginal delivery: more than 50% of women (16/28) presented with PPH with blood loss > 1000 mL (mean blood loss: 1130 mL). Two balloon insertions failures were identified. Bakri balloon success was 100% for women with bleeding < 1000 mL. Twenty-five women (69%) did not require invasive treatment; seven (19%) required arterial embolisation and four (11%) surgical management. No short-term complication was observed after balloon insertion.
  
  
  CONCLUSIONS
  The use of the Bakri™ balloon method, if undertaken early, is effective for the management of PPH with uterine atony (100% success compared to 69% overall success rate). Intrauterine balloon tamponade should included in PPH management guidelines.
authors.affiliation: Department of Obstetrics and Gynecology, Nimes University Hospital, Nîmes, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Vintejoux
authors.affiliation: Department of Obstetrics and Gynecology, Nimes University Hospital, Nîmes, France.|Department of Obstetrics and Gynecology, Graz University Hospital, Graz, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ulrich
authors.affiliation: Department of Obstetrics and Gynecology, Nimes University Hospital, Nîmes, France.
authors.forename: Eve
authors.initials: E
authors.lastname: Mousty
authors.affiliation: Department of Obstetrics and Gynecology, Nimes University Hospital, Nîmes, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Masia
authors.affiliation: Department of Obstetrics and Gynecology, Nimes University Hospital, Nîmes, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Marès
authors.affiliation: Department of Obstetrics and Gynecology, Nimes University Hospital, Nîmes, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: de Tayrac
authors.affiliation: Department of Obstetrics and Gynecology, Nimes University Hospital, Nîmes, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Letouzey
mesh_terms: D000293:Adolescent; D000328:Adult; D001810:Blood Volume; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D061665:Time-to-Treatment; D017211:Treatment Failure; D055357:Uterine Artery Embolization; D058738:Uterine Balloon Tamponade; D014593:Uterine Inertia / Q000209:etiology*; D055815:Young Adult
keywords: Bakri™ balloon; conservative treatment; intrauterine tamponade; post-partum haemorrhage; uterine atony