Abstract

REYNOSA-OVIEDO, Yolanda; LOPEZ-VERA, Ernesto Arnoldo; BAZALDUA-CRUZ, Juan José  and  MARTINEZ-SALAZAR, Gerardo Jesús. Efficacy and safety of uterine tamponade to control bleeding and reduce obstetric hysterectomy: Historic cohort in Nuevo León, México, 2013. Rev Colomb Obstet Ginecol [online]. 2015, vol.66, n.3, pp.186-194. ISSN 0034-7434.  https://doi.org/10.18597/rcog.23.

Objective: Examine the efficacy and safety of uterine tamponade for controlling obstetric bleeding and reducing the need for obstetric hysterectomy. Materials and methods: Historic cohort of adult women diagnosed with obstetric bleeding secondary to uterine atony that did not respond to the initial management, with bleeding of the placental bed secondary to abnormal placentation or to incomplete abortion, subjected to uterine tamponade at the Highly Specialized Gynaecology and Obstetrics Medical Unit No. 23, a Level III Hospital in the city of Monterrey, state of Nuevo Leon, Mexico, between January and December 2013. Information about social, demographic and baseline clinical characteristics, laboratory values before the obstetric event and after the tamponade procedure, as well as the inflation volume of the balloon, the indication of the procedure, the estimated amount of bleeding during the event and after placement of the tamponade balloon, control of bleeding, and need for hysterectomy, was derived from the clinical record. Descriptive statistics, scatter measurements, and central trends were used. Results: Overall, 161 patients between the ages of 16 and 42 years, with a diagnosis of obstetric haemorrhage were included, 147 following delivery or caesarean section, and 14 following miscarriage. A satisfactory result was documented in more than 95 % of cases after delivery or caesarean section, and in more than 93 % post abortion cases. The mean tamponade time for both groups was 20 hours. Conclusions: This study supports the use of uterine tamponade as an effective and safe therapeutic measure to control bleeding and avoid laparotomy or hysterectomy, and to reduce morbidity.

Keywords : Uterine tamponade; Sengstaken-Blakemore balloon; Foley balloon catheter; uterine bleeding; obstetric haemorrhage; obstetric surgical procedures.

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