Abstract

Aim: To evaluate the effect of 2-way Foley's catheter balloon tamponade on controlling immediate postpartum hemorrhage (PPH) in cases of major placenta previa during cesarean section (CS). Methods: We evaluated women with placenta previa from May to November 2015. Women with immediate PPH during CS due to major placenta previa were managed by 2-way Foley's catheter balloon tamponade when medical treatment failed, and before any surgical intervention. Results: Twenty patients, had major placenta previa, were delivered by elective CS and complicated by immediate PPH. Three placenta accreta patients (15%) underwent hysterectomy, 17 (85%) were managed by the 2-way Foley's catheter balloon tamponade. In two patients, Foley's catheter balloon failed to control bleeding and hysterectomy was done immediately. However, Foley's catheter balloon successfully treated the remaining 15 patients. The median bleeding during the operation was 1522.5 (± 619.29) ml. None of them presented complications related to this procedure or required any further invasive surgery. Conclusion: The 2-way Foley's catheter tamponade could be an option to control immediate postpartum hemorrhage resulting from major placenta previa during the cesarean section. This method is simple, cheap, nearly non-invasive and should be considered to reduce the risk of peripartum hysterectomy.

Highlights

  • Postpartum hemorrhage (PPH) is defined as loss of more than 500 ml of blood after delivery.[1]

  • 53 cases were diagnosed with major placenta previa

  • The remaining seventeen patients had severe postpartum hemorrhage which did not respond to medical treatment which included intravenous infusions of oxytocin (10–20 U), intravenous ergometrine (1 mg) and rectal insertion of misoprostol (800 mg)

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Summary

Introduction

Postpartum hemorrhage (PPH) is defined as loss of more than 500 ml of blood after delivery.[1] Loss of more than 1000 ml of blood is considered physiologically significant and can affect the hemodynamic state. Postpartum hemorrhage is the most common cause of maternal mortality in developing countries.[2] Placenta previa is one of the most common causes of obstetrical bleeding and its incidence varies widely. Please cite this paper as: Ali MK, Abbas AM, Abdelbadee AY, Shazly SA, AbdelMagied AM. Use of Foley's catheter balloon tamponade to control placental site bleeding resulting from major placenta previa during cesarean section.

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