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Comparative Study
. 2025 Jan 1;145(1):65-71.
doi: 10.1097/AOG.0000000000005770. Epub 2024 Oct 24.

Effectiveness of the Intrauterine Balloon Tamponade Compared With an Intrauterine, Vacuum-Induced, Hemorrhage-Control Device for Postpartum Hemorrhage

Laurence E Shields  1 , Catherine Klein, Jennie Torti, Mindy Foster, Curtis Cook
Affiliations
Comparative Study

Effectiveness of the Intrauterine Balloon Tamponade Compared With an Intrauterine, Vacuum-Induced, Hemorrhage-Control Device for Postpartum Hemorrhage

Laurence E Shields et al. Obstet Gynecol. .

Abstract

Objective: To compare intrauterine balloon tamponade and vacuum-induced hemorrhage-control devices in a multicenter hospital system using a standardized three-stage postpartum hemorrhage response algorithm.

Methods: As part of a quality improvement project, data were prospectively collected through ongoing detailed hemorrhage case audits from 65 facilities from August 2022 to February 2024. Postpartum hemorrhage-control devices are recommended for stage 2 or 3 of the postpartum hemorrhage algorithm. The primary outcomes were 1) quantitative blood loss after device placement, 2) rate of packed red blood cell (RBC) transfusion, 3) use of 3 units of packed RBCs or more, and 4) device failure.

Results: During the 17-month observation period, there were 123,292 deliveries, and postpartum hemorrhage occurred in 5,931 (4.8%). Postpartum hemorrhage-control devices were used in 11.2% of cases (666 total, intrauterine balloon tamponade n=300, and vacuum-induced hemorrhage control n=366). For intrauterine balloon tamponade and vacuum-induced hemorrhage-control devices, quantitative blood loss (median and interquartile range) after device placement was similar at 194 (67-440) mL and 240 (113-528) mL ( P =.40), respectively, as was the rate of any packed RBC transfusion (59.7% vs 50.0%, P =.08), transfusion of 3 packed RBC units or more (27.0% vs 24.9%, P =.53), and device failure (7.7% vs 8.5%, P =.70). Placement of either device at a quantitative blood loss between 1,000 and 1,499 mL compared with 1,500 mL or more resulted in significantly lower rates of packed RBC transfusion (39.1% vs 70.3%, P <.001), transfusion of 3 or more packed RBC units (13.7 vs 38.1%, P <.001), and device failure (3.4% vs 12.9%, P <.001).

Conclusion: Transfusion and blood loss after device placement were similar with both hemorrhage-control devices. Earlier hemorrhage-control device placement reduced device failure and the need for transfusion.

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Conflict of interest statement

Financial Disclosure The authors did not report any potential conflicts of interest.

References

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