Analysis of prophylactic Bakri balloon tamponade failure in patients with placenta previa
Objective: Recently, Bakri balloon (BBT) was effective for women with placenta previa to reduce hemorrhage. However, about 10% of women needed to receive an invasive strategy. Thus, the identification of risk factors and the development of additional measurements for BBT failure was needed. The aim...
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Elsevier
2019-01-01
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Series: | Taiwanese Journal of Obstetrics & Gynecology |
Online Access: | http://www.sciencedirect.com/science/article/pii/S1028455918303036 |
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doaj-5aecbae27d9f4410b009704fbf2e5141 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hiroaki Soyama Morikazu Miyamoto Hiroki Ishibashi Masaya Nakatsuka Haruka Kawauchi Takahiro Sakamoto Hiroko Matuura Mika Kuwahara Kazuki Takasaki Hideki Iwahashi Kento Kato Masashi Yoshida Masashi Takano Hidenori Sasa Kenichi Furuya |
spellingShingle |
Hiroaki Soyama Morikazu Miyamoto Hiroki Ishibashi Masaya Nakatsuka Haruka Kawauchi Takahiro Sakamoto Hiroko Matuura Mika Kuwahara Kazuki Takasaki Hideki Iwahashi Kento Kato Masashi Yoshida Masashi Takano Hidenori Sasa Kenichi Furuya Analysis of prophylactic Bakri balloon tamponade failure in patients with placenta previa Taiwanese Journal of Obstetrics & Gynecology |
author_facet |
Hiroaki Soyama Morikazu Miyamoto Hiroki Ishibashi Masaya Nakatsuka Haruka Kawauchi Takahiro Sakamoto Hiroko Matuura Mika Kuwahara Kazuki Takasaki Hideki Iwahashi Kento Kato Masashi Yoshida Masashi Takano Hidenori Sasa Kenichi Furuya |
author_sort |
Hiroaki Soyama |
title |
Analysis of prophylactic Bakri balloon tamponade failure in patients with placenta previa |
title_short |
Analysis of prophylactic Bakri balloon tamponade failure in patients with placenta previa |
title_full |
Analysis of prophylactic Bakri balloon tamponade failure in patients with placenta previa |
title_fullStr |
Analysis of prophylactic Bakri balloon tamponade failure in patients with placenta previa |
title_full_unstemmed |
Analysis of prophylactic Bakri balloon tamponade failure in patients with placenta previa |
title_sort |
analysis of prophylactic bakri balloon tamponade failure in patients with placenta previa |
publisher |
Elsevier |
series |
Taiwanese Journal of Obstetrics & Gynecology |
issn |
1028-4559 |
publishDate |
2019-01-01 |
description |
Objective: Recently, Bakri balloon (BBT) was effective for women with placenta previa to reduce hemorrhage. However, about 10% of women needed to receive an invasive strategy. Thus, the identification of risk factors and the development of additional measurements for BBT failure was needed. The aim of our study is to investigate the cause and measurements of failing prophylactic BBT in women with placenta previa. Materials and methods: Women with placenta previa who underwent cesarean section and had a prophylactic BBT inserted during the operation at our institution between January 2015 and December 2017 were enrolled. Patients requiring additional procedures after cesarean section for massive hemorrhage were defined as BBT failures. Additionally, the patterns and risk factors of BBT failure were retrospectively evaluated. Results: Seventy women met the inclusion criteria. Of them, 9 (13%) were in the balloon failure group and 61 (87%), in the balloon success group. Between two groups, the median of postoperative blood loss was 1153 g vs. 70 g (p < 0.01) and the total blood loss 2409 g vs. 971 g (p < 0.01). There were two types of failures in the balloon failure group: balloon prolapse in eight patients (89%) and accidental placental retention in one patient (11%). The hemorrhage was controlled in all patients with balloon prolapse by reinsertion and inflation of the balloon. The patient with placental retention required a uterine artery embolization (UAE). Although three patients required a blood transfusion, none required a hysterectomy. The logistic regression for the risk of balloon failure revealed classification of major previa to be the highest risk factor (Hazard Ratio; 19.1, 95% Confidence Interval; 3.17–367.9, p < 0.01). Conclusion: The major cause of BBT failure was balloon prolapse. It could be treated with non-invasive methods; however, patients with placental retention could not avoid invasive treatment to stop the hemorrhage. Keywords: Bakri balloon, Cesarean section, Placenta previa, Postpartum hemorrhage, Uterine atony |
url |
http://www.sciencedirect.com/science/article/pii/S1028455918303036 |
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doaj-5aecbae27d9f4410b009704fbf2e51412020-11-25T01:37:07ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592019-01-01581159163Analysis of prophylactic Bakri balloon tamponade failure in patients with placenta previaHiroaki Soyama0Morikazu Miyamoto1Hiroki Ishibashi2Masaya Nakatsuka3Haruka Kawauchi4Takahiro Sakamoto5Hiroko Matuura6Mika Kuwahara7Kazuki Takasaki8Hideki Iwahashi9Kento Kato10Masashi Yoshida11Masashi Takano12Hidenori Sasa13Kenichi Furuya14Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanCorresponding author. Department of Obstetrics and Gynecology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.; Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa 359-8513, JapanObjective: Recently, Bakri balloon (BBT) was effective for women with placenta previa to reduce hemorrhage. However, about 10% of women needed to receive an invasive strategy. Thus, the identification of risk factors and the development of additional measurements for BBT failure was needed. The aim of our study is to investigate the cause and measurements of failing prophylactic BBT in women with placenta previa. Materials and methods: Women with placenta previa who underwent cesarean section and had a prophylactic BBT inserted during the operation at our institution between January 2015 and December 2017 were enrolled. Patients requiring additional procedures after cesarean section for massive hemorrhage were defined as BBT failures. Additionally, the patterns and risk factors of BBT failure were retrospectively evaluated. Results: Seventy women met the inclusion criteria. Of them, 9 (13%) were in the balloon failure group and 61 (87%), in the balloon success group. Between two groups, the median of postoperative blood loss was 1153 g vs. 70 g (p < 0.01) and the total blood loss 2409 g vs. 971 g (p < 0.01). There were two types of failures in the balloon failure group: balloon prolapse in eight patients (89%) and accidental placental retention in one patient (11%). The hemorrhage was controlled in all patients with balloon prolapse by reinsertion and inflation of the balloon. The patient with placental retention required a uterine artery embolization (UAE). Although three patients required a blood transfusion, none required a hysterectomy. The logistic regression for the risk of balloon failure revealed classification of major previa to be the highest risk factor (Hazard Ratio; 19.1, 95% Confidence Interval; 3.17–367.9, p < 0.01). Conclusion: The major cause of BBT failure was balloon prolapse. It could be treated with non-invasive methods; however, patients with placental retention could not avoid invasive treatment to stop the hemorrhage. Keywords: Bakri balloon, Cesarean section, Placenta previa, Postpartum hemorrhage, Uterine atonyhttp://www.sciencedirect.com/science/article/pii/S1028455918303036 |