title: Impact of uterine balloon tamponade on the use of invasive procedures in severe postpartum hemorrhage.
abstract: BACKGROUND
  The aim of this study was to assess the impact of tamponade when uterotonic agents fail, on the need for surgery or interventional radiology.
  
  
  METHODS
  All women who received sulprostone for postpartum hemorrhage were retrospectively compared over two periods [December 2008 to December 2010 without use of tamponade (period 1) and June 2011 to June 2013 with use of tamponade (period 2)] in the case of sulprostone failure (STROBE compliant retrospective cohort study). During period 2, interventional radiology or surgery was used only in the case of tamponade failure.
  
  
  RESULTS
  165 women were included (74 for period 1, 91 for period 2). The rate of interventional radiology or surgery significantly decreased from period 1 (21 of 74 women, 28.4%) to period 2 (six of 91 women, 6.6%, p = 0.0003). The rate of assumed failure of uterotonic agents was higher for period 2: 22 of 74 women (29.7%) during period 1, and 41 of 91 (45.1%, p = 0.0439) during period 2. The success rate of tamponade was 92.1% (35 of 38 women).
  
  
  CONCLUSIONS
  Although the efficacy of tamponade should be viewed in the light of its widespread use, our findings confirm that tamponade significantly reduces the need for interventional radiology or surgery for postpartum hemorrhage treatment.
authors.affiliation: Gynecology and Obstetrics Department, Maternity, Regional University Hospital (CHRU), Nancy, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Gauchotte
authors.affiliation: Gynecology and Obstetrics Department, Maternity, Regional University Hospital (CHRU), Nancy, France.|University of Lorraine, Vandœuvre-lès-Nancy, France.
authors.forename: Manuela
authors.initials: M
authors.lastname: De La Torre
authors.affiliation: Gynecology and Obstetrics Department, Maternity, Regional University Hospital (CHRU), Nancy, France.
authors.forename: Estelle
authors.initials: E
authors.lastname: Perdriolle-Galet
authors.affiliation: Gynecology and Obstetrics Department, Maternity, Regional University Hospital (CHRU), Nancy, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lamy
authors.affiliation: University of Lorraine, Vandœuvre-lès-Nancy, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gauchotte
authors.affiliation: Gynecology and Obstetrics Department, Maternity, Regional University Hospital (CHRU), Nancy, France.|University of Lorraine, Vandœuvre-lès-Nancy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000473:pathology / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D058738:Uterine Balloon Tamponade / Q000706:statistics & numerical data*
keywords: Uterine balloon tamponade; hemostatic techniques; postpartum hemorrhage; pregnancy; sulprostone; uterine hemorrhage