Effectiveness of uterine tamponade devices for refractory postpartum haemorrhage after vaginal birth: a systematic review

被引：14

作者：

Pingray, V ^{[1
]}

Widmer, M. ^{[2
]}

Ciapponi, A. ^{[1
]}

Hofmeyr, G. J. ^{[3
,4
]}

Deneux, C. ^{[5
]}

Gulmezoglu, M. ^{[2
,6
]}

Bloemenkamp, K. ^{[7
]}

Oladapo, O. T. ^{[2
]}

Comande, D. ^{[1
]}

Bardach, A. ^{[1
]}

Vazquez, P. ^{[1
]}

Cormick, G. ^{[1
]}

Althabe, F. ^{[2
]}

机构：

[1] Consejo Nacl Invest Cient & Tecn, Inst Efectividad Clin & Sanit IECS, Buenos Aires, DF, Argentina

[2] WHO, Dept Sexual & Reprod Hlth & Res, World Bank Special Program Res Dev & Res Training, UNDP,UNFPA,UNICEF, Geneva, Switzerland

[3] Univ Botswana, Gaborone, Botswana

[4] Walter Sisulu Univ, Univ Witwatersrand, Effect Care Res Unit, Mthatha, South Africa

[5] Univ Paris, Sorbonne Paris Cite, Obstetr Perinatal & Pediat Epidemiol Res Team, Ctr Epidemiol & Stat,EPOPe,INSERM,INRA,U1153,CRES, Paris, France

[6] Concept Fdn, Geneva, Switzerland

[7] Univ Med Ctr Utrecht, Wilhelminas Children Hosp, Div Woman & Baby, Dept Obstet,Birth Ctr, Utrecht, Netherlands

来源：

BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY | 2021年 / 128卷 / 11期

关键词：

Bakri balloon; condom uterine balloon tamponade; hysterectomy; maternal death; postpartum haemorrhage; uterine atony; vaginal delivery; INTRAUTERINE BALLOON TAMPONADE; BAKRI BALLOON; MANAGEMENT;

D O I：

10.1111/1471-0528.16819

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objectives To evaluate uterine tamponade devices' effectiveness for atonic refractory postpartum haemorrhage (PPH) after vaginal birth and the effect of including them in institutional protocols. Search strategy PubMed, EMBASE, CINAHL, LILACS, POPLINE, from inception to January 2021. Study selection Randomised and non-randomised comparative studies. Outcomes Composite outcome including surgical interventions (artery ligations, compressive sutures or hysterectomy) or maternal death, and hysterectomy. Results All included studies were at high risk of bias. The certainty of the evidence was rated as very low to low. One randomised study measured the effect of the condom-catheter balloon compared with standard care and found unclear results for the composite outcome (relative risk [RR] 2.33, 95% CI 0.76-7.14) and hysterectomy (RR 4.14, 95% CI 0.48-35.93). Three comparative studies assessed the effect of including uterine balloon tamponade in institutional protocols. A stepped wedge cluster randomised controlled trial suggested an increase in the composite outcome (RR 4.08, 95% CI 1.07-15.58) and unclear results for hysterectomy (RR 4.38, 95% CI 0.47-41.09) with the use of the condom-catheter or surgical glove balloon. One non-randomised study showed unclear effects on the composite outcome (RR 0.33, 95% CI 0.11-1.03) and hysterectomy (RR 0.49, 95% CI 0.04-5.38) after the inclusion of the Bakri balloon. The second non-randomised study found unclear effects on the composite outcome (RR 0.95, 95% CI 0.32-2.81) and hysterectomy (RR 1.84, 95% CI 0.44-7.69) after the inclusion of Ebb or Bakri balloon. Conclusions The effect of uterine tamponade devices for the management of atonic refractory PPH after vaginal delivery is unclear, as is the role of the type of device and the setting. Tweetable abstract Unclear effects of uterine tamponade devices and their inclusion in institutional protocols for atonic refractory PPH after vaginal delivery.

引用

页码：1732 / 1743

页数：12

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