Intrauterine balloon tamponade for postpartum hemorrhage

• Autor(a) principal: Dalmedico, Michel Marcos
• Data de Publicação: 2022
• Outros Autores: Barbosa, Felipe Mendes, de Toledo, Caroline Machado, Martins, Waleska Alves, Fedalto, Angela do Rocio, Ioshii, Sergio Ossamu
• Tipo de documento: Artigo
• Idioma: eng; por
• Título da fonte: Fisioterapia em Movimento
• Texto Completo: https://periodicos.pucpr.br/fisio/article/view/28530
• topic: Postpartum hemorrhage. Uterine balloon tamponade. Evidence-based emergency medicine. Systematic review.; Hemorragia pós-parto. Tamponamento com balão uterino. Medicina de emergência baseada em evidências. Revisão sistemática.

Introduction: Postpartum hemorrhage is an obstetric emergency with high prevalence and significant morbidity and mortality, especially in areas with reduced access to specialized health services. Objective: To evaluate the effectiveness of intrauterine balloon tamponade in controlling postpartum hemorrhage, with the aim to reduce the need for emergency surgical interventions and decrease maternal mortality. Methods: A systematic review of randomized clinical trials, guided by the Cochrane Handbook for Systematic Reviews of Interventions and reported through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Randomized clinical trials that evaluated the use of different types of balloons for intrauterine tamponade as a strategy for reducing or stopping postpartum hemorrhage compared to other interventions (pharmacological or surgical) were considered for inclusion. Results: Four studies evaluated 498 patients. In 80% of the reported cases, hemorrhage cessation was observed within a mean interval of 15 min after device insertion. The device permanence time was 24 h. No serious adverse events were reported. Due to clinical heterogeneity between studies, it was not possible to perform a quantitative synthesis. Conclusion: We did not find enough evidence to support the routine use of uterine tamponade devices as a protocol practice in the control of refractory postpartum hemorrhage. However, the use of these devices seems to be promising in cases where first line interventions fail and may play an important role in decreasing maternal morbidity and mortality and in uterine preservation.