The New Indian Journal of OBGYN. Epub Ahead of Print

To compare the role of JH balloon tamponade and Foley’s condom balloon tamponade to control atonic postpartum haemorrhage

Neelam Nalini, Madhumita, Aditya Vardhan Singh, Bijeta Singh

ABSTRACT

Objectives: To compare the efficacy and safety of JH balloon tamponade and Foley’s condom balloon tamponade (FC) to control atonic postpartum haemorrhage. Methods: The prospective randomized control trial was conducted on 100 patients of atonic PPH who were randomly assigned into two groups: Group 1 (50 cases): managed by Foley’s condom balloon and Group 2 (50 cases): managed by JH balloon tamponade. The outcome measures were time of insertion of the UBT and time of stoppage of bleeding. Any side effects or slippage of the balloon was also noted. The patients were followed up at 6 months to determine the long term outcomes in terms of menses, uterine cavity and pregnancies. Results: Success rate was 92% in cases of JH balloon tamponade while it was 88% in cases of FC balloon tamponade respectively (p-0.74). In 6 cases of failure in FC group, 2 each were managed with B-Lynch sutures, uterine artery ligation and sub-total hysterectomy while the 4 cases of failure in JH group were managed by B-Lynch sutures and uterine artery ligation (p=0.418). Mean time to making, insertion and inflation of the catheter (3.01 vs 3.12 mins; p-0.09) and mean time to stop bleeding was comparable between the FC and JH groups (7.08 vs 6.91 mins; p-0.65). In FC group 10 patient out of 50 slippage of balloon tamponade occurred whereas only 1 patient in JH group slippage of JH balloon tamponade occurred (p=0.008). At 6 months follow up, 38 patients in FC group and 40 patients in JH group reported no adverse long term outcomes. They had normal menstrual cycles with no subsequent pain during that period. Conclusion: In conclusion, success rate of Foley’s condom balloon and JH balloon tamponade was good and comparable (88% and 92% respectively). Both balloon tamponade utilizes the existing resources to their best and can be easily made even in resource poor peripheral health center without wastage of time. So both type of balloon can be successfully used in atonic PPH protocols before opting for surgical options.