Original Research

Efficacy of Intrauterine Balloon Tamponade in the Management of Postpartum Hemorrhage when Uterotonic Agents Fail

DOI https://doi.org/10.70302/jpsim.v6i4.2568
Received: 30 May 2025 Revised: 28 Aug 2025 Accepted: 10 Nov 2025 Published Online: 21 Nov 2025

Abstract

Objective

To determine the efficacy of intrauterine balloon tamponade in the management of postpartum hemorrhage when uterotonic agents fail.

Methods

It was a descriptive case series study carried out in Obstetrics & Gynecology Department, Lady Aitchison Hospital, Lahore for 6 months.35 females were enrolled. Females underwent balloon tamponade by using condom. Then females kept under observation in ward for 15 minutes. If blood flow stopped within 15 minutes and no recurrence occurred after removing tamponade after 24 hours, then efficacy was labeled using SPSS 26.

Results

Mean age of patients was 26.4±3.81 years, there were 9(27%) nulliparous. The Mean gestational age was 38.22±0.68 weeks. In this study the efficacy of balloon tamponade achieved among 30(86%) females.

Conclusion

Intrauterine balloon tamponade is efficacious tool for postpartum hemorrhage management when uterotonic agents fail.

Keywords
Uterotonic Efficacy Intrauterine Balloon Tamponade PPH

How to Cite This Article

Munir M, Mukhtar H, Irshad S, Ghaffar S, Ayyaz M. Efficacy of Intrauterine Balloon Tamponade in the Management of Postpartum Hemorrhage when Uterotonic Agents Fail. J Pak Soc Intern Med. 2025;6(4):368–372. doi:10.70302/jpsim.v6i4.2568

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. Lutomski J, Byrne B, Devane D, Greene R. Increasing trends in atonic postpartum haemorrhage in Ireland: an 11‐year population‐ based cohort study. Int J Obstet Gynaecol. 2012;119(3):306-14.
  2. Radon C, Divers M. Increasing trends in atonic postpartum haemorrhage in Ireland: an 11‐year population‐based cohort study. Int J Obstet Gynaecol. 2012;119(9):1149-50.
  3. Shuja S, Ansar A, Liaquat NF. Primary PPH; Role of uterine packing in control of haemorrhage. Professional Med J.2008;15(3):335-40.
  4. Organization WH. WHO recommendatioins for the prevention and treatment or postpartum haemorrhage. Updated 2012. Assessed from: [www.who.int/iris/bitstream/10665/75411/1/9789241548502_eng.pdf]
  5. Avery DM. Review of Medical and Surgical Management of Postpartum Hemorrhage. Am J Clin Med. 2011;8(1):6-10.
  6. Su CW. Postpartum hemorrhage. Primary Care: Clinics in Office Practice. 2012;39(1):167-87.
  7. de Lange NM, Lance MD, de Groot R, Beckers EA, Henskens YM, Scheepers HC. Obstetric hemorrhage and coagulation: an update. Thromboelastography, thromboelastometry, and conventional coagulation tests in the diagnosis and prediction of postpartum hemorrhage. Obstet Gynecol Surv. 2012 ;67(7):426-35.
  8. Diemert A, Ortmeyer G, Hollwitz B, Lotz M, Somville T, Glosemeyer P, et al. The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage. Am J Obstet Gynecol. 2012;206(1):65.
  9. Soon R, Aeby T, Kaneshiro B. Cesarean scar dehiscence associated with intrauterine balloon tamponade placement after a second trimester dilation and evacuation. Hawaii Med J. 2011;70(7):137.
  10. Kong M, To W. Balloon tamponade for post partum haemorrhage: case series and literature review. Hong Kong Med J. 2013;19(6):484-90.
  11. Tindell K, Garfinkel R, Abu‐Haydar E, Ahn R, Burke T, Conn K, et al. Uterine balloon tamponade for the treatment of postpartum haemorrhage in resource‐poor settings:a systematic review. Am J Clin Med.. 2013;120(1):5-14.
  12. Akhter S, Begum MR, Kabir Z, Rashid M, Laila TR, Zabeen F. Use of a condom to control massive postpartum hemorrhage. Med Gen Med. 2003 11;5(3):38.
  13. Dabelea V, Schultze PM, McDuffie RS. Intrauterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol. 2007;24(6):359-64.
  14. Doumouchtsis SK, Papageorghiou AT, Vernier C, Arulkumaran S. Management of postpartum hemorrhage by uterine balloon tamponade: prospective evaluation of effectiveness. Acta Obstet Gynecol Scand. 2008;87(8):849-55.
  15. Bose P, Regan F, Paterson Brown S. Improving the accuracy of estimated blood loss at obstetric haemorrhage using clinical reconstructions. BJOG 2006;113:919-924.
  16. Shakur H, Roberts I, Fawole B, Chaudhri R, El-Sheikh M, Akintan A, et al. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post- partum haemorrhage (WOMAN): an international, randomised, double- blind, placebo-controlled trial. Lancet. 2017;389(10084):2105-16.
  17. Calvert C, Thomas SL, Ronsmans C, Wagner KS, Adler AJ, Filippi V. Identifying regional variation in the prevalence of postpartum haemorrhage: a systematic review and meta-analysis. PloS one. 2012;7(7):e41114.
  18. Khan RU, El-Refaey H. Pathophysiology of postpartum hemorrhage and third stage of labor. Postpartum Hemorrhage. 2006:93(3);243-53.
  19. Doumouchtsis SK, Papageorghiou AT, Arulkumaran S. Systematic review of conservative management of postpartum hemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv. 2007;62(8):540-7.
  20. Mohamed MAM. Knowledge of midwives towards Primary Postpartum Hemorrhage in Khartoum State: Alzaeim Alazhari University; 2015.
  21. Donnay F. Maternal survival in developing countries: what has been done, what can be achieved in the next decade. Int J Gynecol Obstet. 2000;70(1):89-97.
  22. Roopnarinesingh SS. The young Negro primigravida in Jamaica. Int J Obstet Gynaecol. 1970;77(5):424-6.
  23. Organization WH, Unicef. Trends in maternal mortality: 1990- 2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015.
  24. Kodkany B, Derman R. Pitfalls in assessing blood loss and decision to transfer. A textbook of postpartum hemorrhage. 2006.
  25. Behling DJ, Renaud M. Development of an obstetric vital sign alert to improve outcomes in acute care obstetrics. Nurs Women's Health. 2015;19(2):128-41.
  26. Pacagnella RC, Souza JP, Durocher J, PerelP, Blum J,Winikoff B, et al. A systematic reviewof the relationship between blood lossand clinical signs. PloS one. 2013;8(3):e57594.

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