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Post SE, Rood KM, Kiefer MK. Interventions of Postpartum Hemorrhage. Clin Obstet Gynecol 2023; 66:367-383. [PMID: 37204172 DOI: 10.1097/grf.0000000000000785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Postpartum hemorrhage is a common and potentially life-threatening obstetric complication, with successful management relying heavily on early identification of hemorrhage and prompt intervention. This article will review the management of postpartum hemorrhage, including initial steps, exam-specific interventions, medical therapy, minimally invasive, and surgical interventions.
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Affiliation(s)
- Sara E Post
- Department of Obstetrics and Gynecology, College of Medicine, The Ohio State University, Columbus, Ohio
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Piyadigama I, Banagala C, Kariyawasam L, Jayawardane M. Life-saving with a vaginal condom catheter in postpartum haemorrhage due to vaginal lacerations in a low-resource setting. BMJ Case Rep 2021; 14:e245199. [PMID: 34588204 PMCID: PMC8483052 DOI: 10.1136/bcr-2021-245199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Postpartum haemorrhage (PPH) due to multiple vaginal lacerations is difficult to manage and tamponade is used as a life-saving measure. Condom catheter with stay sutures at the vaginal introitus for this purpose has not been reported. We describe successfully managing PPH due to multiple vaginal lacerations following a forceps delivery using a condom tied to an 18 FG Foley catheter. The device was introduced to the vagina, inflated with 700 mL of normal saline and was held in situ by sealing the vaginal introitus with interrupted nylon stitches running between the labia minora. Condom catheter is cheap and freely available in low-resource settings. The preparation and application can be done by a less experienced operator.
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Affiliation(s)
- Indunil Piyadigama
- Obstetrics and Gynaecology, Castle Street Hospital for Women, Colombo 8, Sri Lanka
| | | | - Lakshman Kariyawasam
- Obstetrics and Gynaecology, Castle Street Hospital for Women, Colombo 8, Sri Lanka
| | - Madura Jayawardane
- Obstetrics and Gynaecology, University of Sri Jayewardenepura Faculty of Medical Sciences, Nugegoda, Sri Lanka
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Kong CW, To WWK. Use of balloon tamponade in management of vaginal laceration and its possible complication of urinary stress incontinence: a case report. BMC Pregnancy Childbirth 2020; 20:214. [PMID: 32293311 PMCID: PMC7161190 DOI: 10.1186/s12884-020-02885-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postpartum haemorrhage from vaginal lacerations can occasionally be refractory to suturing and vaginal packing. Bakri uterine balloon has been widely adopted to stop uterine bleeding, but its use to stop bleeding in vaginal lacerations and its possible complications have seldom been reported. CASE PRESENTATION We report a patient who had vacuum delivery for fetal distress and subsequently had postpartum hemorrhage due to previous caesarean uterine scar rupture and multiple vaginal lacerations. The severe bleeding persisted despite total abdominal hysterectomy, pelvic embolization and vaginal gauze packing, but was finally controlled by a Bakri balloon tamponade inserted into the vagina. The patient suffered from severe stress incontinence after delivery. The possible use of balloon tamponade in vaginal lacerations and the different types of vaginal balloons that are available in the market for this purpose are reviewed. The possible causes leading to stress incontinence is reported to alert the obstetrician that such management is not free of complications. CONCLUSION The use of Bakri balloon can help to control bleeding in severe vaginal lacerations that are unresponsive to traditional vaginal gauze packing. Further studies are needed to evaluate the risks of stress incontinence as a possible complication of vaginal balloon tamponade.
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Affiliation(s)
- Choi Wah Kong
- Department of Obstetrics and Gynaecology, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Hong Kong SAR.
| | - William Wing Kee To
- Department of Obstetrics and Gynaecology, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Hong Kong SAR
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Fadel MG, Das S, Nesbitt A, Killicoat K, Gafson I, Lodhi W, Yoong W. Maternal outcomes following massive obstetric haemorrhage in an inner-city maternity unit. J OBSTET GYNAECOL 2019; 39:601-605. [PMID: 30821181 DOI: 10.1080/01443615.2018.1534814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This retrospective study evaluates the effects of a massive postpartum haemorrhage (PPH) on maternal outcomes in an inner-city London hospital. One hundred and eighty-four cases of a massive primary PPH (>2000 mL) were identified over a seven-year period. A sub-group analysis was performed to assess whether 2000-3000 mL blood loss (134 cases) was associated with specific maternal characteristics or reduced adverse outcomes compared with >3000 mL blood loss (50 cases). Bakri balloon tamponade (BBT) was the most frequent form of surgical management in both groups (21 vs. 46%), followed by compression sutures (16.4 vs. 24%), the 'uterine sandwich' technique (6.7 vs. 14%) and the hysterectomy (0 vs. 4%). There were significant differences between these groups in placenta praevia as the cause of blood loss (8 vs. 22%, p = .01), length of stay (4.6 vs. 5.9 d, p = .02), use of BBT (p = <.01) and hysterectomy (p = .03). PPH is associated with premature maternal morbidity and mortality. The incidence is increasing in high income countries despite various guidelines, skills training and identification of risk factors. A prediction and assessment of blood loss remain the very cornerstone for a prompt, effective management. Our study shows that the morbidity is clearly related to the amount of blood loss and highlights the existing variable practices for the management of PPH. Impact statement What is already known on this subject? A postpartum haemorrhage (PPH) remains a common cause of maternal morbidity and mortality. Massive PPH (>2000 mL) rates continue to rise in developed countries. The management of PPH includes the medical treatment followed by surgical methods including the Bakri balloon tamponade (BBT), compression sutures or a hysterectomy. What do the results of this study add? This retrospective study evaluates the effects of a massive PPH (blood loss >2000 mL) on maternal outcomes. One hundred and eighty-four cases of a massive PPH were identified over a seven-year period. Sub-group analysis was performed to assess whether a 2000-3000 mL blood loss was associated with specific maternal characteristics and differences in obstetric practice compared with a >3000 mL blood loss. There were significant differences between these groups in placenta praevia, as the cause of blood loss, the length of stay, the use of BBT and the hysterectomy rates. What are the implications of these findings for clinical practice and/or further research? An early identification of the risk factors of a massive PPH is essential to improve maternal outcomes and is an important part of the antenatal, intrapartum and postpartum period. The prediction and assessment of blood loss remain key for a prompt, effective management. The amount of blood loss is related to adverse maternal outcomes and the management techniques applied. BBT has an essential role to play and should be included as part of the core training in the management of a PPH.
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Affiliation(s)
- Michael G Fadel
- a Department of Obstetrics and Gynaecology , North Middlesex University Hospital , London , UK
| | - Sayantana Das
- a Department of Obstetrics and Gynaecology , North Middlesex University Hospital , London , UK
| | - Alexander Nesbitt
- a Department of Obstetrics and Gynaecology , North Middlesex University Hospital , London , UK
| | - Kathryn Killicoat
- a Department of Obstetrics and Gynaecology , North Middlesex University Hospital , London , UK
| | - Irene Gafson
- a Department of Obstetrics and Gynaecology , North Middlesex University Hospital , London , UK
| | - Wasim Lodhi
- a Department of Obstetrics and Gynaecology , North Middlesex University Hospital , London , UK
| | - Wai Yoong
- a Department of Obstetrics and Gynaecology , North Middlesex University Hospital , London , UK
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Innovative Uses of Condom Uterine Balloon Tamponade for Postpartum Hemorrhage in India and Tanzania. Case Rep Obstet Gynecol 2018; 2018:4952048. [PMID: 29967704 PMCID: PMC6008944 DOI: 10.1155/2018/4952048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/07/2018] [Indexed: 01/04/2023] Open
Abstract
Background Postpartum hemorrhage is the most common cause of maternal deaths worldwide, the majority of which occur in low-resource settings. Uterine balloon tamponade (UBT) is an effective method of addressing uncontrolled postpartum hemorrhage (PPH) from uterine atony; however, UBT devices are often not affordable. We report on three novel uses of an ultra-low-cost condom uterine balloon tamponade (ESM-UBT) device. Cases ESM-UBT devices were used in innovative ways to arrest severe uncontrolled pregnancy-related hemorrhage among three women in India and Tanzania. The first had sustained deep vaginal lacerations, the second a cervical pregnancy, and the third a complete molar pregnancy. Conclusion The ESM-UBT device may be useful for control of obstetric hemorrhage caused by complex vaginal tears as well as cervical and molar pregnancies.
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Timor-Tritsch IE, Cali G, Monteagudo A, Khatib N, Berg RE, Forlani F, Avizova E. Foley balloon catheter to prevent or manage bleeding during treatment for cervical and Cesarean scar pregnancy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2015; 46:118-123. [PMID: 25346492 DOI: 10.1002/uog.14708] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 08/26/2014] [Accepted: 10/15/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To demonstrate the efficacy of placement and inflation of Foley balloon catheters prophylactically to prevent, or as an adjuvant therapy to control, bleeding in women undergoing treatment for Cesarean scar pregnancy (CSP) or cervical pregnancy (CxP). METHODS This was a retrospective study of 18 women with either CSP (n = 16) or CxP (n = 2), who underwent Foley balloon catheter placement under continuous transvaginal or transabdominal ultrasound guidance to prevent or manage bleeding following treatment, which in most cases comprised local (intragestational sac) and intramuscular (IM) methotrexate (MTX) injections. In eight cases, the balloon catheter was placed immediately following local and/or IM MTX treatment, either because of bleeding or prophylactically; in eight cases, the catheter was placed as part of a two-step protocol, with patients first treated with local and IM MTX injection, then suction aspiration on Day 4 or 5, followed by planned insertion of a balloon catheter; in one patient the balloon was placed on Day 21 after local and IM MTX treatment, due to sudden bleeding; and in one case of a heterotopic pregnancy, one intrauterine and one cervical, the balloon was placed due to severe bleeding. Human chorionic gonadotropin (hCG) levels were evaluated weekly following MTX injection. RESULTS Gestational ages at balloon placement ranged between 5 and 12 + 2 weeks. All embryos/fetuses, with the exception of the cervical heterotopic one, had heart activity and catheter placement was well-tolerated by all women. The balloon tamponade effectively reduced or prevented maternal vaginal bleeding in all except one patient; this woman had a heterotopic CxP and required abdominal robotic cerclage to control the bleeding. Catheters were kept in place for a mean of 3.6 (range, 1-6) days. hCG levels returned to low or zero levels within 19-82 days following MTX injection. Fifteen women required antibiotic treatment following the procedure. One woman with CSP developed an arteriovenous malformation requiring uterine artery embolization. CONCLUSION Ultrasound-guided placement and inflation of Foley balloon catheters was easy to perform and well-tolerated by patients undergoing treatment for CSP or CxP, and successfully prevented or helped in the management of bleeding complications. Based on our experience and previous publications we suggest having the option of balloon catheter insertion available when local treatment of CSP or CxP is undertaken.
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Affiliation(s)
- I E Timor-Tritsch
- New York University School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New York, NY, USA
| | - G Cali
- Arnas Civico Hospital, Department of Obstetrics and Gynecology, Palermo, Italy
| | - A Monteagudo
- New York University School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New York, NY, USA
| | - N Khatib
- Rambam Medical Center, Department of Obstetrics and Gynecology, Haifa, Israel
| | - R E Berg
- New York University School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New York, NY, USA
| | - F Forlani
- Arnas Civico Hospital, Department of Obstetrics and Gynecology, Palermo, Italy
| | - E Avizova
- New York University School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New York, NY, USA
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Atilgan R, Ozkan ZS, Orak U, Baspinar M. Complete tamponade system for management of severe postpartum vaginal haemorrhage due to uterine atony. BMJ Case Rep 2014; 2014:bcr-2014-205872. [PMID: 25452297 DOI: 10.1136/bcr-2014-205872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 30-year-old, 39 weeks pregnant, multiparous woman with single fetus, attended our obstetric clinic with complete cervical dilation in intractable mentum anterior presentation. The fetus was delivered by caesarean section with vertical uterine incision under general anaesthesia and lithotomy position. After surgery, examination of the vagina revealed multiple, serious tears with severe haemorrhage. Vaginal bleeding could not be controlled by sutures and concurrently uterine atony developed, which could not be controlled with medical treatment. Owing to intractable bleeding from uterus and vagina, a complete tamponade system was used. After the instillation of the uterine balloon with 500 mL and vaginal balloon with 300 mL liquid, the bleeding was controlled. The estimated blood loss was 3200 mL. The vaginal wound healed well during the postoperative 2 weeks. A complete tamponade system may be an effective treatment method for treatment of postpartum haemorrhage owing to vaginal lacerations and uterine atony.
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Affiliation(s)
| | - Zehra Sema Ozkan
- Department of Obstetrics and Gynaecology, Fırat University Faculty of Medicine, Elazig, Turkey
| | - Ugur Orak
- Department of Obstetrics and Gynaecology, Fırat University Faculty of Medicine, Elazig, Turkey
| | - Melike Baspinar
- Department of Obstetrics and Gynaecology, Fırat University Faculty of Medicine, Elazig, Turkey
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Morel O, Perdriolle-Galet E, Mézan de Malartic C, Gauchotte E, Moncollin M, Patte C, Chabot-Lecoanet AC. Prise en charge obstétricale en cas d’hémorragie du post-partum qui persiste malgré les mesures initiales ou qui est sévère d’emblée, après accouchement par voie basse. ACTA ACUST UNITED AC 2014; 43:1019-29. [DOI: 10.1016/j.jgyn.2014.09.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Georgiou C. A review of current practice in using Balloon Tamponade Technology in the management of postpartum haemorrhage. HYPERTENSION RESEARCH IN PREGNANCY 2014. [DOI: 10.14390/jsshp.2.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Christos Georgiou
- Faculty Science, Medicine and Health, Graduate School of Medicine, University of Wollongong
- Wollongong Hospital, Australia
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Nesbitt A, Rai N, Limbu J, Leslie I, Yoong W. To tamponade or not to tamponade? Acta Obstet Gynecol Scand 2013; 92:1118-9. [DOI: 10.1111/aogs.12172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 05/10/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Alexander Nesbitt
- University College London and Royal Free School of Medicine; London UK
- Department of Obstetrics and Gynaecology; North Middlesex University Hospital; London UK
| | - Nabita Rai
- University College London and Royal Free School of Medicine; London UK
- Department of Obstetrics and Gynaecology; North Middlesex University Hospital; London UK
| | - Jhuma Limbu
- University College London and Royal Free School of Medicine; London UK
- Department of Obstetrics and Gynaecology; North Middlesex University Hospital; London UK
| | - Isla Leslie
- University College London and Royal Free School of Medicine; London UK
- Department of Obstetrics and Gynaecology; North Middlesex University Hospital; London UK
| | - Wai Yoong
- University College London and Royal Free School of Medicine; London UK
- Department of Obstetrics and Gynaecology; North Middlesex University Hospital; London UK
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Ajayi OA, Sant M, Ikhena S, Bako A. Uterine rupture complicating sequential curettage and Bakri balloon tamponade to control secondary PPH. BMJ Case Rep 2013; 2013:bcr-2012-007709. [PMID: 23391948 DOI: 10.1136/bcr-2012-007709] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 20-year-old para 2 woman had a preterm delivery at 25 weeks and 6 days, readmitted to the hospital 25 days after delivery with severe secondary postpartum haemorrhage (PPH). Uncontrolled by initial conservative management, she underwent uterine curettage followed by Bakri balloon tamponade. She later had laparotomy for continued bleeding. She was found to have uterine rupture and hysterectomy was carried out as a life-saving measure. She was transfused in total with 14 units of blood, 1 unit of platelet, 2 units of cryoprecipitate and 3 units of fresh frozen plasma. The patient had intensive therapy unit care and was discharged home on the sixth postoperative day. The histology report showed ectatic non-constricted vessels as the cause of the secondary PPH. No myometrial tissue, products of conception or evidence of endometritis. The sequential use of uterine curettage and balloon tamponade in the aetiology of uterine rupture is a rare occurrence.
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Grönvall M, Tikkanen M, Tallberg E, Paavonen J, Stefanovic V. Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: a series of 50 cases from a tertiary teaching hospital. Acta Obstet Gynecol Scand 2012; 92:433-8. [PMID: 22913383 DOI: 10.1111/j.1600-0412.2012.01531.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Massive postpartum hemorrhage (PPH) is one of the most serious complications during delivery. Hysterectomy is commonly performed when other conventional treatment attempts fail. Bakri balloon tamponade (BBT) is a novel conservative management option for PPH. Little is known of the effectiveness of this procedure. We report a large case series from a tertiary teaching hospital. DESIGN Retrospective case series (October 2008-June 2011). SETTING University teaching hospital. POPULATION Forty-four women with massive PPH (blood loss >1000 mL) and six other women with expected high risk of PPH (blood loss <1000 mL) managed by BBT. METHODS Chart review. MAIN OUTCOME MEASURES Achievement of definitive hemostasis by BBT among the study population. RESULTS Among the women treated with BBT, the cause of PPH was uterine atony (16%), cervical rupture (14%), vaginal rupture and/or paravaginal hematoma (22%), placenta previa (18%) and placental retention (30%). The overall success rate was 86%. Seven of the 50 patients needed additional procedures. Of the seven failures, supravaginal uterine amputation or hysterectomy was required in four cases and embolization of the uterine arteries in three cases. CONCLUSIONS BBT is a simple, readily available, effective and safe procedure for the management of PPH in selective cases. BBT does not exclude the use of other procedures if necessary. Even if BBT failed, it may provide temporary tamponade and time to prepare for other interventions or transportation from local hospital to tertiary centre. We suggest that BBT should be included in the PPH protocol.
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Affiliation(s)
- Maiju Grönvall
- Department of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland
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Ghirardini G, Alboni C, Mabrouk M. Use of balloon tamponade in management of severe vaginal postpartum hemorrhage and vaginal hematoma: a case series. Gynecol Obstet Invest 2012; 74:320-3. [PMID: 22907127 DOI: 10.1159/000339931] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 06/03/2012] [Indexed: 11/19/2022]
Abstract
Severe vaginal lacerations and hematomas can be serious, life-threatening complications of vaginal delivery. The management is usually limited to suturing and vaginal packing with gauze. After a vaginal delivery vaginal tissues can be edematous, friable and very difficult to suture. Vaginal balloon tamponade can be a solution in difficult cases of intractable vaginal hemorrhage or occult vaginal bleeding causing vaginal hematoma. We describe the use of a new balloon device for vaginal hemostasis in 4 cases to treat bleeding and prevent hematoma formation from postpartum vaginal lacerations. According to our experience, the use of this balloon tamponade system in treating severe vaginal postpartum hemorrhage seems to be safe, effective and well tolerated by the patients.
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Affiliation(s)
- Giuseppe Ghirardini
- Obstetrics and Gynecology Unit, New Civil Hospital of Sassuolo, Sassuolo, Italy
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Srivastava G, Bartlett C, Thakur Y. Successful use of Rusch balloon to control postpartum haemorrhage due to vaginal lacerations. J OBSTET GYNAECOL 2012; 32:36. [PMID: 22185533 DOI: 10.3109/01443615.2011.615416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- G Srivastava
- Department of Obstetrics, and Gynaecology, Basildon and Thurrock University Hospital, Basildon, UK.
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Blood pressure cuff tamponade of vaginal lacerations causing significant postpartum hemorrhage. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2012; 33:1207. [PMID: 22166273 DOI: 10.1016/s1701-2163(16)35103-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Raynal P. Le ballonnet de Bakri. ACTA ACUST UNITED AC 2011; 39:438-41. [DOI: 10.1016/j.gyobfe.2011.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 12/06/2010] [Indexed: 10/18/2022]
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Yoong W, Ray A, Phillip SA. Balloon tamponade for postpartum vaginal lacerations in a woman refusing blood transfusion. Int J Gynaecol Obstet 2009; 106:261. [PMID: 19428012 DOI: 10.1016/j.ijgo.2009.03.052] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Revised: 03/05/2009] [Accepted: 03/24/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Wai Yoong
- Department of Obstetrics and Gynecology, North Middlesex University Hospital, London, UK.
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Balloon Compression as Treatment for Refractory Vaginal Hemorrhage. Ann Emerg Med 2008; 52:148-50. [DOI: 10.1016/j.annemergmed.2008.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 03/28/2008] [Accepted: 04/02/2008] [Indexed: 11/18/2022]
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Liu CB, Cho FN, Chiang AJ, Yu KJ. Life-threatening Postpartum Hemorrhage Successfully Treated with a colorectal double balloon. Taiwan J Obstet Gynecol 2008; 47:233-4. [DOI: 10.1016/s1028-4559(08)60091-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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