title: Use of Condom Tamponade to Manage Massive Obstetric Hemorrhage at a Tertiary Center in Rajasthan.
abstract: BACKGROUND
  Conventionally postpartum hemorrhage (PPH) has been defined as blood loss of more than 500 ml following vaginal delivery and 1000 ml following a cesarean section [Pritchard et al. in Am J Obstet Gynecol 84(10):1271-1282, (1962)]. Another definition labels PPH as any blood loss which causes a 10 % drop in hematocrit [Combs et al. in Obstet Gynecol 77:69-76, (1991)] or which threatens the hemodynamic stability of the patient and necessitates blood transfusion [Prendiville et al. in Cochrane Database Syst Rev 2:CD000007, (2000)]. The purpose of this study was to evaluate the effectiveness of condom tamponade in the management of massive obstetric hemorrhage.
  
  
  OBJECTIVE
  To evaluate the efficacy of a condom as a tamponade for intrauterine pressure to stop massive PPH.
  
  
  METHODS
  This prospective study was done in the Obstetrics and Gynecology Department of NIMS Medical College and Hospital, Jaipur, between December 2013 and February 2015. With aseptic precautions, a sterile rubber catheter fitted with a condom was introduced into the uterus. The condom was inflated with 250-500 ml normal saline according to need. Vaginal bleeding was observed, and further inflation was stopped when bleeding ceased.
  
  
  RESULTS
  In all but 2 (94.44 %) the cases, postpartum bleeding was stopped within 10 min of creation of tamponade. On an average, 350 ml of normal saline was required to create adequate tamponade to stop the bleeding.
  
  
  CONCLUSIONS
  Use of condom tamponade can effectively help in reducing both maternal morbidity and mortality associated with PPH. Our study encourages use of condom tamponade which is efficient, cost-effective, easily available and requires lesser skills as compared to the traditional surgical procedures.
authors.affiliation: NIMS University Jaipur, Shri Ganeshkrupa Niwas, 1328/1, Plot No-1A, Balaram Colony 6th Lane, Sutarmal, Kolhapur, 416010 India.
authors.forename: Rakesh
authors.identifier: 0000-0001-5370-9046
authors.initials: R
authors.lastname: Hasabe
authors.affiliation: NIMS University Jaipur, Shri Ganeshkrupa Niwas, 1328/1, Plot No-1A, Balaram Colony 6th Lane, Sutarmal, Kolhapur, 416010 India.
authors.forename: Kumud
authors.initials: K
authors.lastname: Gupta
authors.affiliation: NIMS University Jaipur, Shri Ganeshkrupa Niwas, 1328/1, Plot No-1A, Balaram Colony 6th Lane, Sutarmal, Kolhapur, 416010 India.
authors.forename: Pallavi
authors.initials: P
authors.lastname: Rathode
keywords: Condom tamponade; Intrauterine pressure to stop massive PPH; Obstetric hemorrhage; Shivkar’s Pack