Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Faculty of Medicine, Cairo University, Cairo, Egypt.
J Matern Fetal Neonatal Med. 2021 Jan;34(2):300-307. doi: 10.1080/14767058.2019.1605349. Epub 2019 Apr 24.
Postpartum hemorrhage (PPH) is a direct cause of maternal death all over the world. A Bakri balloon is recommended by American College of Obstetricians and Gynecologists (ACOG) and World Health Organization (WHO) as a treatment line for PPH unresponsive to uterotonics. We carried out a systematic review to assess the safety and effectiveness of Bakri balloon in the management of PPH. We searched PubMed, SCOPUS, central Cochrane, and Web of Science, from 2001 to 2018 for randomized controlled trials (RCTs) and observational studies to assess the safety and effectiveness of Bakri balloon on refractory PPH. Twenty-eight articles were included for analysis. The primary indication for the use of a Bakri balloon tamponade was PPH. Only 67.9% (19/28) quantified the estimate blood loss necessary to use the balloon. Uterine atony was the underlying cause of PPH in 75% (21/28) of studies. Most of the studies on Bakri balloon are followed by vaginal birth (3/4). Bakri balloon displacement from the uterine cavity was reported by five publications, with the overall rate being 9% (95% CI: 5-15%). Hysterectomy was necessary for 1% (95% CI: 0-8%) of the women who required the balloon. Bakri balloon seems to be a less effective tool for management of PPH either after vaginal or cesarean delivery.
产后出血（PPH）是全世界产妇死亡的直接原因。美国妇产科医师学会（ACOG）和世界卫生组织（WHO）推荐 Bakri 球囊作为对宫缩剂无反应的 PPH 的治疗方案。我们进行了一项系统评价，以评估 Bakri 球囊在治疗 PPH 中的安全性和有效性。我们检索了 2001 年至 2018 年的 PubMed、SCOPUS、Cochrane 中心和 Web of Science，以评估 Bakri 球囊对难治性 PPH 的安全性和有效性的随机对照试验（RCT）和观察性研究。有 28 篇文章纳入分析。使用 Bakri 球囊填塞的主要指征是 PPH。只有 67.9%（19/28）定量了使用球囊所需的估计失血量。75%（21/28）的研究中 PPH 的根本原因是子宫收缩乏力。大多数关于 Bakri 球囊的研究都是阴道分娩（3/4）后进行的。有五篇文献报道了 Bakri 球囊从子宫腔移位，总发生率为 9%（95%CI：5-15%）。需要行子宫切除术的妇女占 1%（95%CI：0-8%）。Bakri 球囊似乎是阴道分娩或剖宫产产后出血管理的效果较差的工具。
