Maternal outcomes after use of Bakri balloon tamponade in the treatment of severe postpartum hemorrhage in women with placenta accreta after natural childbirth
Maternal outcomes after use of Bakri balloon tamponade in the treatment of severe postpartum hemorrhage in women with placenta accreta after natural childbirth
Objective:To explore the maternal outcomes of Bakri balloon tamponade(BBT)in the treatment of severe postpartum hemorrhage in women with placenta accreta after natural childbirth.Methods:A total of 170 women with placenta accreta presenting with severe postpartum hemorrhage(sPPH)after natural childbirth were retrospectively included in our hospital from January 2016 to December 2020.All eligible women received BBT treatment.The clinical baseline characteristics,perinatal outcomes between women with Bakri success and Bakri failure,women with placenta accreta and without placenta accretawere collected and analyzed.Results:Among these women selected,placental implantation accounted for 51.76％(88/170)and BBT showed an effectiveness of 87.65％(149/170).Women with placenta accrete had a lower BBT success rate than those without placenta accrete(x2=5.73,P=0.017).Compared towomen with BBT failure,women with BBT success had a significantly reduced pre/post-BBT blood loss,a prolonged duration from delivery to balloon placement,a prolonged balloon retention time(all P＜0.05).Compared to women without placenta accrete,women with placenta accrete showed a significantly higher pre-BBT blood loss and the more volume of physiological saline,but a shorter duration from delivery to balloon placement(all P＜0.05).Conclusion:Placenta accrete is the main cause of sPPH in women with natural childbirth.Though BBT showed a slightly lower effectiveness in women with placenta accrete than those without placenta accrete,an early and precise use of Bakri BBT after delivery may contribute to hemostasis success,especially in women with placenta accrete.
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