CONTROLLED UTERINE BALLOON TAMPONADE AS A METHOD FOR PREVENTION OF ACUTE MASSIVE BLOOD LOSS DURING CESAREAN SECTION

Objective. To improve the outcomes of treatment for postpartum hypotonic uterine bleeding, by applying a preventive approach. Subjects and methods. A prospective cohort study was conducted in 51 women with indications for cesarean section and no history of conditions and pathological processes that directly threatened to the lives of a mother and a baby. Group 1 included 25 women in whom controlled uterine cavity balloon tamponade (CBT) therapy was preventively used through a hysterotomic incision after placental removal during cesarean section. Group 2 comprised patients in whom no balloon catheter was inserted into the uterine cavity. Results. Based on the study inclusion criteria, all the women had these or those risk factors for postpartum obstetric hemorrhage. Hemotransfusions were performed in 4 (15.3%) in Group 2, but were not in Group 1. The results of the treatment showed the efficiency and prospects of the author’s proposed technology. The mean resuscitative care duration was significantly shorter in Group 1 (1.1±0.2 days) than in Group 2 (2.4±0.3 days) (p<0.05; t=4.3). In Group 2 patients, the discharge time was 4.48±0.08 days, which was also longer than that in Group 2 (4.15±0.11 days) (p<0.05; t=2.75). Conclusion. The proposed CBT technology reduces the risk of massive obstetric blood loss, the duration of resuscitative care, and the use of blood preparations and antibiotics and allows the results of treatment to be improved in women with obstetric hemorrhage caused by uterine hypotonia, by saving the organ. The indication for preventive uterine CBT must be the risk factors of obstetric blood loss, which are based on the life, obstetric history, and current pregnancy histories.

controlled uterine cavity balloon tamponade, cesarean section, risk groups