Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan.
Acta Obstet Gynecol Scand. 2019 Dec;98(12):1612-1617. doi: 10.1111/aogs.13692. Epub 2019 Sep 12.
Postpartum hemorrhage is the most common cause of maternal death worldwide. Although intrauterine balloon tamponade has been widely used as an effective procedure to control atonic postpartum hemorrhage, intrauterine balloon tamponade fails to control postpartum hemorrhage in approximately one-fifth of cases. The aim of this study was to evaluate the efficacy of novel intrauterine balloon tamponade systems for postpartum hemorrhage.
We have developed two novel intrauterine balloon tamponade systems to maintain proper balloon placement. One was a shaft cover with its fixture system and the other was "the Kyoto balloon system" designed to provide direct pressure onto the upper uterine cavity. The efficacy of the intrauterine balloon tamponade systems was evaluated using a silicone three-dimensionally printed postpartum uterine cavity model.
Measurements of balloon displacement during inflation showed that the shaft cover significantly prevented the Bakri balloon from being displaced. The residual fluid volume in the upper uterine cavity was significantly less with the Kyoto balloon system than with the Bakri balloon system, indicating the effectiveness of the Kyoto balloon for upper uterine cavity tamponade.
These innovative intrauterine balloon tamponade systems were effective for prevention of balloon displacement and for balloon tamponade of the upper uterine cavity in a 3D-printed postpartum-specific uterine cavity model.
产后出血是全球范围内导致产妇死亡的最常见原因。尽管宫腔内球囊压迫已被广泛用于控制宫缩乏力性产后出血，但约有五分之一的病例宫腔内球囊压迫无法控制产后出血。本研究旨在评估新型宫腔内球囊压迫系统治疗产后出血的疗效。
我们开发了两种新型宫腔内球囊压迫系统，以保持球囊的正确位置。一种是带有固定装置的轴套，另一种是“京都球囊系统”，旨在对宫腔上部提供直接压力。使用硅胶三维打印产后子宫腔模型评估宫腔内球囊压迫系统的疗效。
充气过程中球囊位移的测量结果表明，轴套可显著防止 Bakri 球囊移位。与 Bakri 球囊系统相比，京都球囊系统宫腔上部的残留液体量明显减少，表明京都球囊对宫腔上部的压迫效果更好。
这些创新性宫腔内球囊压迫系统在预防球囊移位和在 3D 打印产后特定子宫腔模型中对宫腔上部进行球囊压迫方面均有效。
