Background: Intrauterine balloon tamponade (IUBT), specifically the usage of Bakri balloon tamponade (BBT), is an effective conservative management technique for postpartum haemorrhage (PPH). The primary objective was to evaluate local guidelines and contribute to evidence regarding ideal duration for BBT. The secondary objectives were to consider impacts on maternal-foetal wellbeing, and optimise healthcare efficiency by reducing length of ICU admissions.
Methods: This five-year retrospective case series analysed 132 cases of obstetric ICU admissions requiring Bakri balloon insertion for PPH within our centre. Additionally, a prospective patient experience survey was conducted over six-month period, involving 22 obstetric patients who required unplanned ICU admissions.
Results: Bakri balloon insertion was successful in 95%, whilst 5% experienced failure, necessitating further interventions (uterine artery embolisation) or return to theatre (hysterectomy). The success group demonstrated significant reductions in median blood loss (1.8 L vs. 2.5 L, p = 0.016) and difference in median duration of BBT (18.3 vs. 3.92 hours, p = 0.001). The prospective patient survey revealed a high level of satisfaction of care. Approximately 50% breastfed prior to discharge, on average commencing 23.4 hours post-delivery. This study demonstrates a high success rate of BBT, with failures typically occurring within median duration 3.9 hours.
Conclusions: Considering the separation of mother from baby during the Bakri balloon's presence in ICU, we propose timely removal at around six hours, as failures are unlikely post this timeframe, or nursing these women in a neonatal care setting to facilitate earlier mother-baby bonding.
Keywords: Maternal-child relations; patient experience; postpartum haemorrhage; quality of health care; uterine balloon tamponade.
The Bakri balloon is a medical tool used to stop heavy bleeding after childbirth. This study looked at how well the Bakri balloon worked and how it affected mothers’ experiences. We found that the balloon was successful in most cases, but when it didn’t work, the failure usually happened within the first four hours.One of the main concerns mothers expressed was being separated from their newborns while they were in the intensive care unit. Our findings suggest that if the Bakri balloon can be safely removed sooner, it may help reduce the time mothers spend in intensive care, allowing them to bond with their babies earlier. This bonding time is important for both emotional well-being and overall satisfaction with care.