Abstract

Introduction: Postpartum haemorrhage (PPH) is a preventable cause of maternal mortality and Active management of the third stage of laborious considered a gold standard for the management and prevention of PPH. Oxytocics like Oxytocin, Carbetocin, Methergin and Misoprostol are the mainstays of the management of PPH. When medical methods fail intrauterine balloon, tamponade has been suggested as an effective uterine conserving procedure, minimally invasive and requires less skill. The purpose of this study was to determine the indications, complications and effectiveness of Bakri balloon insertion performed at the tertiary care teaching hospital.
Patients and Methods: All cases of Bakri balloon insertion done between 1-01-2020 to 31-12-2021 at the Department of Gynecology and Obstetrics were retrospectively collected. The study group included women for whom the balloon was inserted vaginally and after caesarean delivery when medical methods fail to control PPH and PPH following Placenta previa. Demographic data, clinical characteristics, indications of Bakri balloon, amount of normal saline used, duration of Bakri balloon inside uterus, complications and effectiveness of Bakri balloon were studied.
Results: There were 24 patients who underwent Bakri balloon insertion. 14 patients were delivered by Cesarean section and 10 patients were delivered by vaginal delivery. 16 were multigravida and the majority were from the rural population. The most common indication for a Bakri balloon in our study is the Atonic uterus. The Bakri balloon was effective in 83.33%. (20/24). Out of 4 women, two women required emergency peripartum hysterectomy and 2 women expired.
Conclusion: The Bakri balloon was highly effect vein our study and can be used when medical management fails. It reduces the need for peripartum hysterectomy and saves woman reproductive function. It avoid sun necessary blood product transfusion and reduces the duration of hospital stay.