Time Determination of Permanence of the Sengstaken Blakemore Ballon in Relation with the Clinical Outcome in Postpartum Hemorrhage Patients
Obstetrics & Gynecology International Journal
Postpartum hemorrhage is one of the leading causes of maternal death in the world, representing the 27 %. More than two thirds of these cases have been classified as postpartum hemorrhage (PPH). The guidelines for the treatment of PPH implicate a step by step focus, initiating with the exclusion of retained placental tissue, genital tract trauma, uterine massage and multiple uterotonic agents. If bleeding control is not accomplished, it requires surgical intervention like compression sutures,
... pression sutures, internal iliac artery ligation and obstetric hysterectomy. Recently the balloon uterine tamponade has been added to the management of PPH. Here in the High Specialty Unit we use the Sengstaken Blakemore (SSB) balloon as uterine tamponade. Objectives: Comparing the time of the SSB balloon permanence in relation to the bleeding control success in postpartum hemorrhage patients. Methods: A comparative, retrospective and transversal analytical study will be carried out in patients that had there pregnancy terminated in this unit and was treated with SSB uterine tamponade. Results: Registries were obtained from 149 files from patients with PPH that were treated with SSB uterine tamponade in a period of time understood from 2013-2014, a success rate was found with SSB uterine tamponade of 92.62% (P=<0.001), it was estimated that over 20.5 hours (SEN 52.9%, SPE 77.2%) doesn't offer greater benefit carrying out the permanence of the SSB uterine tamponade, securely removing the tamponade at this time. Conclusion: The SSB uterine tamponade is being used in Monterrey, Nuevo Leon with a greater success rate than the one reported in literature; the age of the patient and the number of pregnancies are variables that can predict the probable success of the treatment, and that once installed the ideal time of permanence of the uterine tamponade can be less than 20.5 hours. Graphic 1: Age of the patients is equally with a less quantity of pregnancies with in average. Graphic 2: Age of the patients is equally with a less quantity of pregnancies with in average.