Perforation with Bakri balloon into broad ligament during management of postpartum hemorrhage

Abstract

An 18-year-old woman presented from an outside hospital 12 hours after vaginal delivery complicated by postpartum hemorrhage, which had been managed with uterotonics, dilation and curettage, and placement of a Bakri balloon followed by vaginal packing. Upon arrival, the patient’s vital signs were within normal limits; however, she complained of severe lower abdominal pain. The fundus was palpated in the left lower quadrant, and a firm mass was palpated in the right lower quadrant. An abdominal computed tomography scan showed the Bakri balloon (Figure 1, A) and its tip in the right lower abdominal quadrant outside of the uterus (Figure 1, B). Exploratory laparotomy was performed, and the Bakri balloon was visualized within the right broad ligament (Figure 2). The balloon was deflated and removed under visualization. No internal injuries were identified. The patient had an uneventful postoperative recovery course. Manufacturer instructions recommend confirmation of correct Bakri placement by ultrasound. Figure 2Intra-operative photo of balloon (A) within broad ligament of uterus (B) Show full caption Spencer. Perforation with Bakri balloon into broad ligament in postpartum hemorrhage. Am J Obstet Gynecol 2021. View Large Image Figure Viewer Download Hi-res image Spencer. Perforation with Bakri balloon into broad ligament in postpartum hemorrhage. Am J Obstet Gynecol 2021.