Key takeaways:
- Two postpartum hemorrhage-control gadgets resulted in related charges of blood loss, transfusion and system failure.
- Earlier system placement led to considerably decrease charges of transfusions and system failure.
MINNEAPOLIS — Girls with postpartum hemorrhage had related transfusion charges and blood loss with intrauterine balloon tamponade and vacuum-induced gadgets, with earlier placement decreasing system failure and the necessity for transfusion, information present.
“Instruments obtainable to the clinician for therapy [of postpartum hemorrhage] have modified little,” Laurence E. Shields, MD, maternal-fetal drugs specialist at Dignity Well being Perinatal & Girls’s Middle, stated throughout a presentation on the ACOG Annual Medical & Scientific Assembly. “Apart from having standardized tips giving suggestions for the utilization of uterotonics, we nonetheless rely closely on dilation and curettage, interventional radiology and hysterectomy, in addition to hemorrhage-control gadgets, which historically have been balloon and, extra just lately, the addition of the JADA suction system.”
Shields and colleagues collected information on postpartum hemorrhage case audits at 65 amenities from August 2022 to February 2024 to check using intrauterine balloon tamponade vs. vacuum-induced hemorrhage-control gadgets. Most of these gadgets are really helpful for stage 2 or 3 of the postpartum hemorrhage algorithm, in response to the researchers.
Main outcomes had been quantitative blood loss after system placement, packed crimson blood cell transfusion charges, use of three or extra packed crimson blood cell models and system failure.
Through the examine interval, 123,292 deliveries occurred, with 4.8% leading to postpartum hemorrhage. Of those circumstances, 11.2% had been managed with postpartum hemorrhage-control gadgets: 45.1% with intrauterine balloon tamponade and 54.9% with vacuum-induced hemorrhage management.
The intrauterine balloon tamponade and vacuum-induced hemorrhage management gadgets had related charges of quantitative blood loss (194 mL vs. 240 mL), packed crimson blood cell transfusion (59.7% vs. 50%) and system failure (7.7% vs. 8.5%).
As well as, in contrast with placement at a quantitative blood lack of 1,500 mL or extra, earlier placement of both system between 1,000 and 1,499 mL led to considerably decrease charges of packed crimson blood cell transfusion (70.3% vs. 39.1%), transfusion of three or extra models of packed crimson blood cells (38.1% vs. 13.7%; P < .001) and system failure (12.9% vs. 3.4%).
“Our information means that placement of the system ought to happen between 1,000 to 1,500 mL,” Shields stated. “Due to the same outcomes, the selection of which system is used might want to take into account elements reminiscent of price and availability of the system. Ideally, all well being care professionals needs to be skilled in each gadgets.”
