Condom-catheter tamponade for the treatment of postpartum haemorrhage and factors associated with success: a prospective observational study.

OBJECTIVE: To determine the outcomes and factors associated with postpartum haemorrhage (PPH) treatment with condom-catheter uterine balloon tamponade (C-UBT). DESIGN: Prospective observational study. SETTING: A secondary healthcare facility in Nigeria. POPULATION: Women with PPH refractory to first-line treatment. METHODS: Demographic and clinical characteristics were compared in women with successful and unsuccessful treatment. Univariate and multivariate logistic regression analyses were used to examine the association of these characteristics with successful treatment. MAIN OUTCOME MEASURES: The success rate of C-UBT, factors associated with success, and maternal morbidity rates in both successful and unsuccessful treatment groups. RESULTS: Overall, 203/229 (88.6%) women had successful treatment. Women with successful treatment had lower mean blood loss (1248.8 ± 701.3 ml versus 3434.6 ± 906.6 ml; P < 0.0001), lower occurrence of blood transfusion [139 (68.5%) versus 26 (100%); P < 0.0001], lower intensive care unit admission rates [5 (2.5%) versus 20 (76.9%); P < 0.0001], and lower occurrence of infectious morbidities [3 (1.5%) versus 7 (26.9%); P < 0.0001]. In the regression model with two factors, caesarean section (adjusted odds ratio, aOR 0.17; 95% confidence interval, 95% CI 0.07-0.40) was associated with lower success rates compared with vaginal delivery. In the regression model with three factors, advanced maternal age (aOR 0.31; 95% CI 0.11-0.90) and caesarean section (aOR 0.17; 95% CI 0.07-0.41) were associated with lower success rates in comparison with younger maternal age and vaginal delivery, respectively. CONCLUSIONS: Second-line PPH treatment with C-UBT is effective, and is associated with low maternal morbidity rates. Advanced maternal age and caesarean section are associated with lower success rates. TWEETABLE ABSTRACT: Condom-catheter tamponade is a useful second-line treatment modality for intractable postpartum haemorrhage.

Antioxidant status and reproductive hormones in women during reproductive, perimenopausal and postmenopausal phase of life.

BACKGROUND: Reproductive aging resulting in menopause with permanent cessation of ovarian follicular activity. The progressive loss of estrogen and its protective effects, combined with deficient endogenous antioxidant results in oxidative stress. OBJECTIVE: To assess the level of oxidative stress and its relationship with reproductive hormones at various developmental phases of women. METHODS: A total of 186 (65 in Reproductive, 58 in Perimenopausal, and 63 in Postmenopausal phase) participants between the ages of 20-60 years were recruited for the study. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, estradiol, total antioxidant status (TAS), malondialdehyde (MDA) and reduced glutathione (GSH); activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) levels were all determined. RESULTS: FSH, LH and MDA levels were significantly increased during perimenopausal and postmenopausal phases compared to reproductive phase; however, estradiol, progesterone, TAS and GSH levels were significantly decreased during perimenopausal and postmenopausal phases compared to reproductive phase. The erythrocyte activities of GSH-Px, SOD and CAT were significantly decreased during perimenopausal and postmenopausal phases compared to reproductive phase. It was observed that MDA showed positive correlation with LH and FSH while a negative correlation with estradiol and progesterone was observed; whereas, antioxidants showed negative correlation with LH and FSH while a positive correlation with estradiol and progesterone. CONCLUSION: The present study revealed that normal perimenopausal and postmenopausal phase are associated with oxidative stress. Therefore it may be of benefit when both phases are being managed in term of hormonal deficit if antioxidant is an adjunct.