Experience of combined use of a Bakri uterine balloon and a non-pneumatic anti-shock garment in a university hospital in Colombia

Abstract

Objective: To compare the outcomes of women with postpartum hemorrhage (PPH) refractory to initial management and in a state of hypoperfusion between management with a non-pneumatic anti-shock garment (NASG) and Bakri balloon and management with other surgical interventions.

Methods: A retrospective observational descriptive study of women with PPH and hemorrhagic shock who were treated at a high complexity obstetric unit in Columbia between 2011 and 2017. Clinical records were reviewed and women were divided in two groups by clinical management. Group 1 women were managed with surgical interventions; group 2 women were managed with NASG plus a Bakri balloon.

Results: Overall, 142 women were treated for PPH, with 69 in group 1 and 73 in group 2). There were differences between group 1 and group 2 in the degree of hypovolemic shock (shock index: 1.1 vs 0.9, P=0.02), indicators associated with hypoperfusion (lactic acid, 2.9 vs 1.9 mmol/L, P=0.001), and frequency of transfusion of blood components (68% vs 44%, P<0.05).

Conclusions: The joint use of NASG and Bakri balloon in PPH management seemed to improve hypoperfusion-related markers such as lactic acid and shock index, and reduce the frequency of additional blood transfusion.

Keywords: Bakri balloon; Hemorrhagic shock; Hypoperfusion; Maternal hemorrhage; Non-pneumatic anti-shock garment; Postpartum hemorrhage; Pregnancy complications.