Introduction: Postpartum hemorrhage (PPH) accounts for a significant proportion of maternal deaths,particularly in low- and middle-income countries. Early recognition and timely management of PPH areessential to prevent severe maternal complications and mortality. Various conservative management techniquessuch as intrauterine balloon tamponade and uterine compression sutures have been used to control bleeding andpreserve the uterus. The present study was conducted to assess the effectiveness of intrauterine balloontamponade in controlling hemorrhage and preventing hysterectomy.Materials and Methods: This hospital-based cross-sectional observational study was conducted at ZananaHospital attached to Sawai Man Singh (SMS) Hospital, Jaipur, Rajasthan, over a period of 18 months fromJanuary 2021 to June 2022. A total of 128 patients with severe postpartum hemorrhage were included in thestudy. Data were collected using a structured questionnaire.Results: The mean maternal age was 31.6 ± 5.3 years. The majority of cases occurred following cesareandelivery (64.1%). Uterine atony was the most common cause of PPH (64.1%), followed by placenta previa(14.1%) and placenta accreta spectrum disorders (12.5%). Intrauterine balloon tamponade was performed in 104patients after failure of medical management. Balloon tamponade alone successfully controlled bleeding in 63patients (60.6%), while 26 patients (25.0%) required additional B-Lynch sutures. Balloon tamponade failed in15 patients (14.4%). Overall, uterine preservation was achieved in 115 patients (89.8%), whereas hysterectomywas required in 13 patients (10.2%). Placenta accreta spectrum disorders, previous cesarean section, higherestimated blood loss, and greater transfusion requirements were significantly associated with hysterectomy.Conclusion: Severe postpartum hemorrhage was most commonly caused by uterine atony. Intrauterine balloontamponade, either alone or in combination with B-Lynch sutures, was effective in controlling hemorrhage in themajority of patients or helped preserve the uterus in most cases. Early recognition of PPH and timely use ofconservative surgical techniques may reduce the need for hysterectomy and improve maternal outcomes.
Chittara et al. (2024) studied this question.