Because of the fear we as obstetricians has of receiving a patient with massive postpartum hemorrhage (PPH), we try to improve our response to this extreme emergency. Postpartum hemorrhage is a major cause of pregnancy related death in both developed and developing nations. Bakri balloon is one of these improvements, which, I believe, is one of the most important advances for treating serious postpartum hemorrhage. I’ll explain here why this device should be utilized more often when treatment with uterotonics hasn’t adequately resolved bleeding.
In 1992, Dr Younes Bakri introduced intrauterine balloon tamponade for the treatment of obstetric hemorrhage during cesarean delivery (1-4). Both the International Federation of Gynaecology and Obstetrics (FIGO) and the International Confederation of Midwives (ICM) have approved the balloon as one of the primary support measures in treating PPH (3, 5). A number of recent reports have described the successful use of balloon tamponade to manage hemorrhage from the lower uterine segment due to placenta previa accreta (6-8).
Bakri balloon is a silicone balloon of a 24-French, 54-cm long, silicone catheter with a filling capacity of 500-mL (3, 4). Ductile shape allows it to conform to uterine anatomy and shape. Added to that, it
…show more content…
While, an assistant working from below helps pull the distal end of the balloon shaft through the cervix into the vagina. After proper insertion of the catheter, the balloon is inflated by 50–100 mL of normal saline. After closure of the uterus and caesarian section scar balloon will be further inflated up to 300-500 mL until the blood draining through catheter is significantly decreased. Post-balloon application, low-dose intravenous oxytocin infusion usually maintained for 24 hours. The drainage amount usually checked hourly for the first 6 hours and if < 100 mL/h, every 4 h