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Research Article

Bakri balloon in the management of postpartum haemorrhage – a single centre experience

Tihomir Totev, Mila Kayryakova, Georgi Stamenov.

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Introduction: Postpartum haemorrhage (PPH) remains a leading cause of maternal morbidity and mortality and sometimes requires a hysterectomy. Several studies have shown the haemostatic effectiveness of a Bakri intrauterine haemostatic balloon, and this needs further examination in a single-centre study. Materials and methods: This is an observational cohort retrospective single-centre study evaluating the effect of a Bakri balloon tamponade on the reduction of the rate of postpartum hysterectomy. Results: A total of 96 patients were treated for PPH resistant to pharmacological measures and were included in this study. In 88 (91.7%) patients, the Bakri balloon tamponade was performed during or after a caesarean section. The indication for the Bakri balloon was as follows: 73 (76%) for uterine atony; 7 (7.3%) for placenta accreta spectrum; 4 (4.2%) for retained placenta; 6 (6.3%) for secondary PPH; 5 (5.2%) for laceration of the genital tract, and 1 (1%) for uncontrolled bleeding from an intramural leiomyoma. Bakri balloon achieved hemostasis in 91 (94.8%), and the remaining 5 (5.2%) required a hysterectomy, 47,9% of the patients had undergone laparoscopic or hysteroscopic interventions, and 60,4% had conceived after IVF procedures. Conclusions: This single-centre study identified the Bakri balloon tamponade as an effective treatment for PPH.

Key words: Postpartum haemorrhage, Bakri balloon, hysterectomy

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