Suarez S, Conde-Agudelo A, Borovac-Pinheiro, Suarez-Rebling D, et al. International Journal of Gynaecology & Obstetrics, 2020.
This systematic review and meta-analysis was conducted to evaluate the efficacy, effectiveness, and safety of uterine balloon tamponade (UBT) for the management of PPH. Ninety-one studies, including 4729 women, met inclusion criteria (6 randomized trials, 1 cluster randomized trial, 15 nonrandomized studies, and 69 case series).
Key Findings
The overall pooled success rate of uterine balloon tamponade in the treatment of postpartum hemorrhage was 85.9%.
- UBT has a high success rate for treating severe PPH and appears to be safe.
- The success rate was higher in women with PPH due to uterine atony (87.1%) and placenta previa (86.8%) than in women with PPH due to placenta accreta spectrum (66.7%) or retained products of conception (76.8%).
- UBT success rate was lower in caesarean deliveries (81.7%) than in vaginal deliveries (87.0%)
- The frequency of complications associated with the use of uterine balloon tamponade was low (<6.5%).
The authors state that the evidence on UBT efficacy and effectiveness from randomized and nonrandomized studies is conflicting, with experimental studies suggesting no beneficial effect, while observational studies show effectiveness of UBT. To optimize maternal outcomes, they suggest high-quality implementation research is needed to determine the most effective programmatic and healthcare delivery strategies on UBT introduction and use, adequately integrating the intervention into systems of emergency care.