Abstract: Introduction: Post-Partum haemorrhage accounts for a quarter of maternal mortality all over the world. In 2017 atonic haemorrhage was the cause for more than 38000 maternal death among which >90% happened in (LMIC’s) low and middle income countries. In low resource countries PPH is the foremost, 30%, cause of maternal mortality. Thus we are in a need to develop cheap and economically feasible method for PPH management.
Materials and Methods: We conducted a prospective intervention study to evaluate the effectiveness of condom catheter balloon tamponade in atonic PPH management and its efficacy to reduce the need for surgical intervention. Condom balloon tamponade kit assembled with reference to C-G Balloon and inserted into the uterine cavity when atonic PPH becomes refractory to medical management.
Observation & Results: In this study, out of 41 mothers with atonic PPH, success rate of condom balloon tamponade was 76.9% without any need for surgical intervention. In the remaining 23.1%, 7.7% needed hysterectomy. In all the failed patients, hysterectomy was required in 75% to control the haemorrhage and this was found to be statistically significant (Pearson’s chi- square test was used p <0.05).
Discussion: The effectiveness of condom tamponade in reducing the need for invasive procedures like compression sutures, uterine artery ligation and hysterectomy was proved in 89.7% of patients with PPH. All the 4 Patients in whom tamponade failed to achieve haemostasis underwent caesarean section and developed intra operative atonic haemorrhage. We observed that uterine atonicity developing intra-operatively during caesarean section highly required invasive surgical intervention like compression sutures and hysterectomy as heamostasis was not achieved with condom balloon tamponade.
Conclusion: The results of our study was comparable to that conducted by Condous GS et al. Who evaluated the efficacy of tamponade test in the management of massive PPH in 16 patients. The timely usage of condom catheter balloon tamponade decreased the mortality rate and also the morbidity following surgical intervention and anaesthetic complications in atonic PPH patients.
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