use of Sengstaken - Blakemore tube to control postpartum hemorrhage: Ain Shams University experience

To evaluate the efficacy of Sengstaken - Blakemore tube to control cases of intractable postpartum hemorrhage [PPH]. Cases of intractable PPH admitted at Ain Shams University Maternity Hospital from April 2005 to December 2006 and managed by Sengstaken-Blakemore tube after exclusion of other causes of PPH are reviewed. Eighteen cases were managed by Sengstaken-Blakemore tube. The most common cause of PPH was uterine atony in 10 cases [56%] followed by coagulopathy in 5 [28%] and placenta accreta in 3 [17%]. Twelve cases [66%] were delivered vaginally and six cases had a cesarean section. The procedure successfully arrested the bleeding in 16 out of 18 cases [88.8%]. All six cases delivered by cesarean section had additionally internal iliac artery ligation before applying the Sengstaken-Blakemore tube However, in cases delivered vaginally, tile balloon was used first in order to avoid laparatomy. The mean blood transfusion unit given was 4.5 units of packed RBCs and 2.1 units fresh frozen plasma. Time mean volume of maximum balloon inflation was 225 ml and the mean duration of application was 33 hours with a mean blood loss through the drainage tube of 233.3 ml. The two unsuccessful cases followed vaginal deliveries and both were salvaged by undergoing supravaginal hysterectomy after failure of internal iliac artery ligation in controlling bleeding. The application of Sengstaken-Blakemore tube in selected cases of intractable PPH appears to be simple, safe and atraumatic sparing patients an unnecessary difficult surgical intervention

use of Sengstaken - Blakemore tube to control postpartum hemorrhage: Ain Shams University experience

To evaluate the efficacy of Sengstaken- Blakemore tube to control cases of intractable postpartum hemorrhage [PPH]. Cases of intractable PPH admitted at Ain Shams University Maternity Hospital from April 2005 to December 2006 and managed by Sengstaken Blakemore tube after exclusion of other causes of PPH are reviewed. Eighteen Cases were managed by Sengstaken- Blakemore tube. The most common cause of PPH was uterine atony in 10 cases [56%] Followed by coagulopathy in 5 [28%] and Placenta accreta in 3 [17%] Twelve cases [66%] were delivered vaginally and six cases had a cesarean section. The procedure successfully, arrested the bleeding in 16 out of 18 cases [88.8%]. All six Cases delivered by cesarean section had additionally internal iliac artery ligation before applying the Sengstaken- Blakemore tube. However, in cases delivered vaginally, the balloon Was used first in order to avoid laparatomy The mean blood transfusion unit given was 4.5 units of packed RBCs and 2.1 units fresh frozen plasma. The mean volume of maximum balloon inflation was 225 ml and the mean duration of application was 33 hours with a mean blood loss through the drainage tube of 233.3 ml. The two unsuccessful cases followed vaginal deliveries and both were salvaged by undergoing supravaginal hysterectomy after failure of internal iliac artery ligation in controlling bleeding. The application of Sengstaken- Blakemore tube in selected cases of intractable PPH appear to be simple safe and atraumatic sparing patients an unnecessary difficult surgical intervention