Abstract
(Acta Obstet Gynecol Scand. 2019;98:1473–1482) Peripartum hysterectomy can be life-saving in the setting of postpartum hemorrhage (PPH). However, it produces infertility and is therefore considered a treatment of last resort. Many other procedures are first attempted to control PPH in an effort to avoid peripartum hysterectomy, such as intrauterine balloon tamponade, uterine compression sutures, and uterine artery ligation or embolization. Uterine artery embolization and intrauterine balloon tamponade have not previously been compared in terms of their effectiveness in preventing maternal death or near miss in women experiencing PPH. Uterine artery embolization is costly and may lead to thromboembolic events and other complications. Intrauterine balloon tamponade has more recently emerged as a more inexpensive strategy for managing PPH. This study aimed to compare the effectiveness of these 2 techniques for the management of persistent PPH.
Highlights
To compare the outcomes of women who were initially managed by intrauterine balloon tamponade or uterine artery embolization because of persistent postpartum hemorrhage demanding an immediate intervention to control bleeding
No difference in the risk of peripartum hysterectomy and/or maternal death was observed between women who had intrauterine balloon tamponade and women who underwent uterine artery embolization as an initial management for persistent postpartum hemorrhage
These interventions have never been compared in terms of effectiveness of preventing severe maternal outcome and uncertainty persists as to whether intrauterine balloon tamponade is an effective alternative to
Summary
To compare the outcomes of women who were initially managed by intrauterine balloon tamponade or uterine artery embolization because of persistent postpartum hemorrhage demanding an immediate intervention to control bleeding. Insertion of an intrauterine balloon for the purpose of tamponade during postpartum hemorrhage could potentially obviate the need for uter‐ ine artery embolization, and reduce healthcare costs. These interventions have never been compared in terms of effectiveness of preventing severe maternal outcome (ie, maternal death or a near miss averted by a peripartum hysterectomy) and uncertainty persists as to whether intrauterine balloon tamponade is an effective alternative to
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