Objective: To evaluate the rate of success and practicability of the intrauterine tamponade balloon (ITB) for managing PPH as a fertility-sparing tool. Methods: a five-year retrospective monocentric study in a tertiary care center including patients transferred for severe PPH. Results: In 231 patients, the success rate of ITB (n = 57), embolization (n = 58), and medical management (n = 114) was 84.21%, 74.13%, and 76.32%, respectively. Cesarean section during labor did not influence the risk of advanced interventional procedures (AIPs) for patients with ITB (odds ratio [OR] = 1.08) but did so in patients who were under expectant management in the intensive care (OR = 5.29). In the AIP subgroup of the ITB group, hemostasis was significantly deteriorated. Prothrombin time <50% (OR = 11.5), fibrinogen <2 g/L (OR = 6.88), and >4 red blood cells units (RBCs) transfused (OR = 17.2) were associated with a significantly higher risk of failure. Blood loss in the AIP patients in the embolization group was significantly higher. Patients requiring >4 units of RBCs were 22.9 times more likely to have an AIP (p = .0001). Conclusion: Compared with uterine embolization and medical management, ITB use in a tertiary care center was associated with lower risk of undergoing AIP, but further prospective study is required to confirm this.

Habib, N., Luton, D., Centini, G., Renuit, I., Birbarah, C., Ceccaldi, P. (2021). Advanced Interventional Procedures after Intrauterine Tamponade Balloon Insertion in a Tertiary Care Center. JOURNAL OF INVESTIGATIVE SURGERY, 34(4), 373-379 [10.1080/08941939.2019.1637976].

Advanced Interventional Procedures after Intrauterine Tamponade Balloon Insertion in a Tertiary Care Center

Centini, Gabriele;
2021-01-01

Abstract

Objective: To evaluate the rate of success and practicability of the intrauterine tamponade balloon (ITB) for managing PPH as a fertility-sparing tool. Methods: a five-year retrospective monocentric study in a tertiary care center including patients transferred for severe PPH. Results: In 231 patients, the success rate of ITB (n = 57), embolization (n = 58), and medical management (n = 114) was 84.21%, 74.13%, and 76.32%, respectively. Cesarean section during labor did not influence the risk of advanced interventional procedures (AIPs) for patients with ITB (odds ratio [OR] = 1.08) but did so in patients who were under expectant management in the intensive care (OR = 5.29). In the AIP subgroup of the ITB group, hemostasis was significantly deteriorated. Prothrombin time <50% (OR = 11.5), fibrinogen <2 g/L (OR = 6.88), and >4 red blood cells units (RBCs) transfused (OR = 17.2) were associated with a significantly higher risk of failure. Blood loss in the AIP patients in the embolization group was significantly higher. Patients requiring >4 units of RBCs were 22.9 times more likely to have an AIP (p = .0001). Conclusion: Compared with uterine embolization and medical management, ITB use in a tertiary care center was associated with lower risk of undergoing AIP, but further prospective study is required to confirm this.
2021
Habib, N., Luton, D., Centini, G., Renuit, I., Birbarah, C., Ceccaldi, P. (2021). Advanced Interventional Procedures after Intrauterine Tamponade Balloon Insertion in a Tertiary Care Center. JOURNAL OF INVESTIGATIVE SURGERY, 34(4), 373-379 [10.1080/08941939.2019.1637976].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/1078172