Santhoshi D, Yaliwal Rajasri G, Patil Neelamma, Biradar Aruna
Obstetrics and Gynecology, Shri BM Patil Medical College, Hospital and Research Centre, Vijayapura, IND.
Cureus. 2025 Apr 10;17(4):e82052. doi: 10.7759/cureus.82052. eCollection 2025 Apr.
Background Uterine balloon tamponade (UBT) has emerged as a minimally invasive and cost-effective technique for managing atonic postpartum hemorrhage (PPH). This study assesses the safety and efficacy of prophylactic Dr. Burke's Every Second Matters-UBT (ESM-UBT) combined with intramuscular (IM) oxytocin compared to IM oxytocin alone in preventing atonic PPH in high-risk women. Methods This randomized parallel-group trial was conducted over 1.5 years at Shri BM Patil Medical College, Hospital, and Research Centre, Vijayapura, Karnataka. A total of 226 women with high-risk pregnancies for atonic PPH were enrolled and randomized into two groups: Group 1 received prophylactic ESM-UBT with IM oxytocin (10 units), while Group 2 received only IM oxytocin. Blood loss was measured using the Brass V drape (Microtrack Surgicals Co., Ahmedabad, Gujarat, India) and additional gauze pad weight assessment. Hemoglobin levels were recorded pre-delivery and 48 hours postpartum. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY). Results The prophylactic use of ESM-UBT significantly reduced total blood loss (Mean: 198.7 mL vs. 325.2 mL, p= 0.000001) and post-delivery hemoglobin drop (Group 1: 9.9 g/dL vs. Group 2: 9.2 g/dL, p = 0.0049). Blood loss at 5, 10, and 60 minutes postpartum was consistently lower in the ESM-UBT group (p 0.0001). The additional uterotonics and blood transfusion requirement was significantly higher in the IM oxytocin-only group (p = 0.003, p = 0.013, respectively). Conclusion Prophylactic ESM-UBT significantly reduces blood loss and the need for additional interventions in high-risk women, demonstrating its potential as a vital tool in PPH prevention, particularly in resource-limited settings. Its cost-effectiveness and ease of use make it a feasible global solution for improving maternal outcomes.
背景 子宫球囊压迫法（UBT）已成为一种用于处理宫缩乏力性产后出血（PPH）的微创且具成本效益的技术。本研究评估预防性伯克医生的“分秒必争 - UBT”（ESM - UBT）联合肌内注射（IM）缩宫素与单纯肌内注射缩宫素相比，在预防高危女性宫缩乏力性PPH方面的安全性和有效性。方法 这项随机平行组试验在卡纳塔克邦维贾亚普拉的斯里BM帕蒂尔医学院、医院及研究中心进行了1.5年。共有226名有宫缩乏力性PPH高危妊娠的女性入组并随机分为两组：第1组接受预防性ESM - UBT联合肌内注射缩宫素（10单位），而第2组仅接受肌内注射缩宫素。使用布拉斯V型手术单（印度古吉拉特邦艾哈迈达巴德的Microtrack Surgicals公司）和额外纱布垫重量评估来测量失血量。记录分娩前和产后48小时的血红蛋白水平。使用IBM SPSS Statistics for Windows，版本20.0（IBM公司，纽约州阿蒙克）进行统计分析。结果 预防性使用ESM - UBT显著减少了总失血量（平均值：198.7 mL对325.2 mL，p = 0.000001）以及产后血红蛋白下降幅度（第1组：9.9 g/dL对第2组：9.2 g/dL，p = 0.0049）。ESM - UBT组产后5分钟、10分钟和60分钟时的失血量持续较低（p < 0.0001）。仅肌内注射缩宫素组额外宫缩剂和输血需求显著更高（分别为p = 0.003，p = 0.013）。结论 预防性ESM - UBT显著减少高危女性的失血量和额外干预需求，表明其作为PPH预防中重要工具的潜力，特别是在资源有限的环境中。其成本效益和易用性使其成为改善孕产妇结局的可行全球解决方案。
