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Experience of combined use of a Bakri uterine balloon and a non‐pneumatic anti‐shock garment in a university hospital in Colombia
Author(s) -
Escobar María F.,
Suso Juan P.,
Hincapié María A.,
Echavarría María P.,
Fernández Paula,
Carvajal Javier
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12872
Subject(s) - medicine , shock (circulatory) , perfusion , blood transfusion , anesthesia , retrospective cohort study , psychological intervention , surgery , psychiatry
Objective To compare the outcomes of women with postpartum hemorrhage ( PPH ) refractory to initial management and in a state of hypoperfusion between management with a non‐pneumatic anti‐shock garment ( NASG ) and Bakri balloon and management with other surgical interventions. Methods A retrospective observational descriptive study of women with PPH and hemorrhagic shock who were treated at a high complexity obstetric unit in Columbia between 2011 and 2017. Clinical records were reviewed and women were divided in two groups by clinical management. Group 1 women were managed with surgical interventions; group 2 women were managed with NASG plus a Bakri balloon. Results Overall, 142 women were treated for PPH , with 69 in group 1 and 73 in group 2). There were differences between group 1 and group 2 in the degree of hypovolemic shock (shock index: 1.1 vs 0.9, P =0.02), indicators associated with hypoperfusion (lactic acid, 2.9 vs 1.9 mmol/L, P =0.001), and frequency of transfusion of blood components (68% vs 44%, P <0.05). Conclusions The joint use of NASG and Bakri balloon in PPH management seemed to improve hypoperfusion‐related markers such as lactic acid and shock index, and reduce the frequency of additional blood transfusion.