The impact of Bakri balloon tamponade on the rate of postpartum hysterectomy for uterine atony.
OBJECTIVE
Our objective was to evaluate the impact of uterine tamponade with a Bakri balloon on the rate of postpartum hysterectomy due to uterine atony.


METHODS
We performed a retrospective cohort study of all deliveries >20 weeks gestation from January 2002 to March 2013 at Baystate Medical Center. Charts were reviewed to determine incidence of postpartum hysterectomy, Bakri balloon placement, uterine artery embolization (UAE) and the B-Lynch procedure. Patients with evidence of placenta accreta were excluded. The primary outcome was the change in rates of postpartum hysterectomy for uterine atony before and after the introduction of Bakri balloon tamponade, using chi-square testing.


RESULTS
There were 48 767 deliveries during the study period, with 17 950 before and 30 817 after the introduction of the Bakri balloon. A total of 43 Bakri balloons were placed during the study period and 21 hysterectomies were performed for postpartum hemorrhage secondary to uterine atony, 14 before and 7 after the introduction of the Bakri balloon. This was consistent with a decrease in the rate of postpartum hysterectomy from 7.8/10 000 deliveries to 2.3/10 000 deliveries (p = 0.01).


CONCLUSION
Our findings show that utilization of the Bakri balloon is associated with a decreased rate of postpartum hysterectomy.
['Lo|Anderson|A|', 'St Marie|Peter|P|', 'Yadav|Parul|P|', 'Belisle|Elizabeth|E|', 'Markenson|Glenn|G|']
D000328:Adult D016009:Chi-Square Distribution D036861:Delivery, Obstetric D005260:Female D006801:Humans D007044:Hysterectomy D006473:Postpartum Hemorrhage D049590:Postpartum Period D011247:Pregnancy D012189:Retrospective Studies D058738:Uterine Balloon Tamponade D014593:Uterine Inertia
uterine artery embolization B-Lynch postpartum hemorrhage placenta previa uterine artery ligation