Dong Hui, Song Jie, Cui Hongyan, Chen Xu
Department of Obstetrics, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China.
Ann Transl Med. 2022 Jan;10(2):72. doi: 10.21037/atm-22-68.
Low-lying placenta is a special form of placenta previa and a major cause of postpartum hemorrhage (PPH). As an important hemostatic tool, the Bakri balloon is widely used in the prevention and treatment of PPH caused by placenta previa. Few studies have paid attention to the effect of Bakri balloon after vaginal delivery in women with low-lying placenta. The aim of this study is to evaluate the efficacy and safety of prophylactic Bakri balloon tamponade (BBT) after vaginal delivery in women with low-lying placenta based on a retrospective cohort study.
Singleton pregnant women with low-lying placenta who had vaginal deliveries at our hospital between January 2015 to December 2020 were enrolled. Women who received prophylactic balloon tamponade immediately after vaginal delivery were defined as the BBT group, while women who underwent routine procedures after vaginal delivery except immediate balloon tamponade were defined as the non-BBT group. The maternal clinical characteristics and outcomes of the two groups were collected and analyzed retrospectively.
A total of 118 women with low-lying placenta were included in the study, with 47 in the BBT group and 71 in the non-BBT group. The postpartum bleeding amount was 339.19±102.94 mL at 2 hours and 418.11±90.73 mL at 24 hours in the BBT group, while in the non-BBT group the postpartum bleeding amount was 421.55±106.37 mL at 2 hours and 505.11±94.51 mL at 24 hours, with significant differences between the two groups (P<0.05). However, there were no significant differences in the postpartum length of hospital stay (P=0.085) and the incidence of puerperal infection (P=0.244) between the two groups.
Routine use of prophylactic BBT after vaginal delivery can significantly reduce the postpartum bleeding amount in women with low-lying placenta and does not increase the incidence of puerperal infection and the postpartum length of hospital stay.
前置胎盘是胎盘前置的一种特殊形式，是产后出血（PPH）的主要原因。作为一种重要的止血工具，Bakri球囊广泛应用于前置胎盘所致产后出血的防治。很少有研究关注Bakri球囊在前置胎盘孕妇阴道分娩后的效果。本研究旨在基于一项回顾性队列研究，评估预防性Bakri球囊填塞（BBT）在前置胎盘孕妇阴道分娩后的有效性和安全性。
纳入2015年1月至2020年12月在我院阴道分娩的单胎前置胎盘孕妇。阴道分娩后立即接受预防性球囊填塞的妇女被定义为BBT组，而阴道分娩后除立即球囊填塞外接受常规程序的妇女被定义为非BBT组。回顾性收集并分析两组产妇的临床特征和结局。
本研究共纳入118例前置胎盘孕妇，其中BBT组47例，非BBT组71例。BBT组产后2小时出血量为339.19±102.94 mL，产后24小时出血量为418.11±90.73 mL；非BBT组产后2小时出血量为421.55±106.37 mL，产后24小时出血量为505.11±94.51 mL，两组间差异有统计学意义（P<0.05）。然而，两组间产后住院时间（P=0.085）和产褥感染发生率（P=0.244）差异无统计学意义。
阴道分娩后常规使用预防性BBT可显著减少前置胎盘孕妇的产后出血量，且不增加产褥感染发生率和产后住院时间。
