EL MINIA BALLOON ; AIR INFLATED IN CONTROLLING ATONIC POSTPARTUM HEMORRHAGE

Abstract

The present study has been conducted in the emergency Obstetric unit of Beni Mazar general hospital to evaluate the tamponade effect of a newly designed air inflated balloon­ EI- minia balloon in controlling post partum hemorrhage.

A total of 240 patients presented with atonic postpartum hemorrhage complicating vaginal delivery were recruited and screened for admission criteria. After application of the first aid measures, the patients were randomly allocated into 2 groups, the ecobolic group (control group) and the balloon group (study group). A written consent was taken from the patient and her family.

There were no statistically significant difference in both groups regarding age and parity, however more patients in the ecolobic group were delivered outside hospital and the interval between delivery and occurrence of postpartum hemorrhage were earlier in the balloon group.

The success rate (stoppage of bleeding)(effectiveness) was 100% in the balloon group while the failure rate was 26% (19 cases) in the ecobolic group, out of these 19 failed cases 14 cases (74%) responded to the application of El-minia balloon as a secondary intervention line while failure was reported in 5 cases who required surgical intervention (2 cases were subjected to 8-Lynch suture and internal iliac artery Ligation and 3 cases were subjected to peripartum hysterectomy).The Balloon was relatively safe , win only 3 cases (3/120)(2.5%) of side effects(cervical tears (2;1.66) and one case (1/120)(0.83) over inflation of balloon

As regards drugs, fluids and cost of management, more ergometrin, oxytocin and misopristol were needed in the ecobolic group, no difference in the use of dextrose, saline and ringer's infusions between the 2 Groups. More blood loss occurred and also more blood units were transfused in the ecobolic group, the total cost regarding drugs and blood was higher in the ecobolic group.

The clinical performances were different between the 2 groups. The number of nurses and doctors required for management were significantly less in the balloon group. Also the time to regain normal uterine tone , the time spent in ICU and in hospital and the time needed for resuscitation was significantly shorter in the balloon group.