Wang Dongyu, Xu Shuqia, Qiu Xiwen, Zhu Caixia, Li Zhuyu, Wang Zilian, Hou Hongying, Gao Yu, Wang Xiaoyi, He Ping, Qin Yiwei, Liu Lihua
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
J Perinat Med. 2018 Aug 28;46(6):649-656. doi: 10.1515/jpm-2017-0249.
To evaluate the success rate and protocol of the Bakri balloon for postpartum hemorrhage (PPH) in the course of a prospective observational multicenter cohort study in South China.
At 20 hospitals in South China, women with postpartum bleeding who failed to respond to the first-line conservative management and received the Bakri balloon were recruited for the study. Maternal characteristics, PPH characteristics, PPH management and outcomes in regard to the Bakri balloon use were recorded.
A total of 472 women had a Bakri balloon tamponade and 407 (86.23%) women were enrolled (67 after vaginal delivery and 340 either during or after cesarean delivery). The success rate of the Bakri balloon in this study was 91.65% (373/407 women). During vaginal deliveries, the group with a hemorrhage >2000 mL before balloon insertion had significantly more blood loss (551.67±635.17 mL vs. 242.06±313.69 mL, P=0.039) and lower maternal hemoglobin (73±21.77 g/L vs. 92.06±19.60 g/L, P=0.029) after using Bakri balloon than the group with a hemorrhage <1000 mL. Similar data were found during cesarean deliveries. The blood loss before and after balloon insertion were significantly higher in the Bakri balloon failure group (1700±1429.88 mL before and 1209.58±1139.72 mL after using the balloon) than those in the success group [918±493.92 mL before (P=0.002) and 266.57±361.60 mL after using the balloon (P=0.001)].
Rapid diagnosis or prognosis of PPH, in combination with early usage of the Bakri postpartum balloon is more effective for the management of PPH.
在中国南方进行的一项前瞻性观察性多中心队列研究中，评估Bakri球囊治疗产后出血（PPH）的成功率及方案。
在中国南方的20家医院，招募一线保守治疗无效且接受Bakri球囊治疗的产后出血妇女进行研究。记录产妇特征、PPH特征、PPH管理及使用Bakri球囊的结局。
共有472名妇女接受了Bakri球囊填塞，407名（86.23%）妇女被纳入研究（67名经阴道分娩后，340名剖宫产术中或术后）。本研究中Bakri球囊的成功率为91.65%（373/407名妇女）。经阴道分娩时，球囊置入前出血>2000 mL的组在使用Bakri球囊后失血明显更多（551.67±635.17 mL对242.06±313.69 mL，P=0.039），产妇血红蛋白更低（73±21.77 g/L对92.06±19.60 g/L，P=0.029），而出血<1000 mL的组情况则不同。剖宫产时也发现了类似数据。Bakri球囊失败组球囊置入前后的失血量明显高于成功组[使用球囊前分别为1700±1429.88 mL和918±493.92 mL（P=0.002），使用球囊后分别为1209.58±1139.72 mL和266.57±361.60 mL（P=0.001）]。
PPH的快速诊断或预后评估，结合早期使用Bakri产后球囊，对PPH的管理更有效。
