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Intraluminal pressure readings during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage
Article first published online: 26 NOV 2009
DOI: 10.1111/j.1471-0528.2009.02436.x
© 2009 The Authors Journal compilation © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 117, Issue 3, pages 295–303, February 2010
Additional Information
How to Cite
Georgiou, C. (2010), Intraluminal pressure readings during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 295–303. doi: 10.1111/j.1471-0528.2009.02436.x
Publication History
- Issue published online: 12 JAN 2010
- Article first published online: 26 NOV 2009
- Accepted 1 October 2009. Published Online 26 November 2009.
- Abstract
- Article
- References
- Cited By
Keywords:
- Intraluminal pressure;
- intrauterine balloon;
- mechanisms;
- postpartum haemorrhage;
- tamponade test
Please cite this paper as: Georgiou C. Intraluminal pressure readings during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage. BJOG 2010;117:295–303.
Objective To investigate the proposed mechanism by which intrauterine balloons achieve their tamponade effect of creating an ‘intrauterine pressure that is greater than the systemic arterial pressure’.
Design To determine the intraluminal pressures within a Bakri balloon during the establishment of a positive ‘tamponade test’ in the management of postpartum haemorrhage. To correlate these intraluminal pressures with contemporaneous readings of blood pressure recordings as documented from the operating theatre anaesthetic charts.
Setting An obstetric unit (approximately 2400 births) in Wollongong, New South Wales, Australia.
Sample Two women in whom first-line uterotonics were unsuccessful and who required a Bakri balloon to control postpartum haemorrhage secondary to an atonic uterus.
Methods A DigiMano (Netech Corporation, Farmingdale, NY, USA) pressure recorder was attached via a three-way tap to a Bakri balloon. Anaesthetic charts of the two cases were reviewed retrospectively.
Main outcome measures Intraluminal pressure readings were recorded after each 50-ml aliquot of normal saline had been insufflated into the balloon whilst the next aliquot was being prepared.
Results There is a curvilinear relationship between the intraluminal pressure and the balloon volume. The pressure does not exceed the systolic blood pressure of the patient at the time of establishment of a positive tamponade test.
Conclusions The intraluminal pressure within the tamponade balloon does not exceed the systolic blood pressure of the patient when a positive tamponade test is established.