Effectiveness of uterine tamponade devices for refractory postpartum haemorrhage after vaginal birth: a systematic review.
Adult
Delivery, Obstetric
/ adverse effects
Female
Hemostatic Techniques
/ instrumentation
Humans
Hysterectomy
/ mortality
Ligation
/ instrumentation
Maternal Mortality
Postpartum Hemorrhage
/ mortality
Pregnancy
Treatment Outcome
Uterine Artery
/ surgery
Uterine Artery Embolization
/ instrumentation
Uterine Balloon Tamponade
/ instrumentation
Vagina
Bakri balloon
condom uterine balloon tamponade
hysterectomy
maternal death
postpartum haemorrhage
uterine atony
vaginal delivery
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
accepted:
16
04
2021
pubmed:
25
6
2021
medline:
29
9
2021
entrez:
24
6
2021
Statut:
ppublish
Résumé
To evaluate uterine tamponade devices' effectiveness for atonic refractory postpartum haemorrhage (PPH) after vaginal birth and the effect of including them in institutional protocols. PubMed, EMBASE, CINAHL, LILACS, POPLINE, from inception to January 2021. Randomised and non-randomised comparative studies. Composite outcome including surgical interventions (artery ligations, compressive sutures or hysterectomy) or maternal death, and hysterectomy. All included studies were at high risk of bias. The certainty of the evidence was rated as very low to low. One randomised study measured the effect of the condom-catheter balloon compared with standard care and found unclear results for the composite outcome (relative risk [RR] 2.33, 95% CI 0.76-7.14) and hysterectomy (RR 4.14, 95% CI 0.48-35.93). Three comparative studies assessed the effect of including uterine balloon tamponade in institutional protocols. A stepped wedge cluster randomised controlled trial suggested an increase in the composite outcome (RR 4.08, 95% CI 1.07-15.58) and unclear results for hysterectomy (RR 4.38, 95% CI 0.47-41.09) with the use of the condom-catheter or surgical glove balloon. One non-randomised study showed unclear effects on the composite outcome (RR 0.33, 95% CI 0.11-1.03) and hysterectomy (RR 0.49, 95% CI 0.04-5.38) after the inclusion of the Bakri balloon. The second non-randomised study found unclear effects on the composite outcome (RR 0.95, 95% CI 0.32-2.81) and hysterectomy (RR 1.84, 95% CI 0.44-7.69) after the inclusion of Ebb or Bakri balloon. The effect of uterine tamponade devices for the management of atonic refractory PPH after vaginal delivery is unclear, as is the role of the type of device and the setting. Unclear effects of uterine tamponade devices and their inclusion in institutional protocols for atonic refractory PPH after vaginal delivery.
Identifiants
pubmed: 34165867
doi: 10.1111/1471-0528.16819
pmc: PMC9292664
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1732-1743Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : UNDP
Organisme : UNFPA
Organisme : UNICEF
Organisme : WHO
Organisme : World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, WHO
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
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