| Titre |
Uterine balloon tamponade as an adjunct to misoprostol for the treatment of uncontrolled postpartum haemorrhage: a randomised controlled trial in Benin and Mali |
| Auteurs |
DUMONT ALEXANDRE [1],
BODIN CECILE [2],
HOUNKPATIN BENJAMIN IGNACE BODOUNRIN [3],
POPOWSKI THOMAS [4],
TRAORE MAMADOU [5],
PERRIN RENÉ-XAVIER [6],
|
| Journal: |
BMJ Open |
| Catégorie Journal: |
Internationale |
| Impact factor: |
2.369 |
| Volume Journal: |
7 |
| DOI: |
doi: 10.1136/bmjopen-2017-016590 |
| Resume |
Objective To assess the effectiveness of low-cost uterine
tamponade as an adjunct to misoprostol for the treatment
of uncontrolled postpartum haemorrhage (PPH) in lowresource
settings.
Design Randomised controlled trial.
Setting Seven healthcare facilities in Cotonou, Benin and
Bamako, Mali.
Population Women delivering vaginally who had clinically
diagnosed PPH that was suspected to be due to uterine
atony, who were unresponsive to oxytocin and who needed
additional uterotonics.
Methods Women were randomly assigned to receive
uterine balloon tamponade with a condom-catheter device
or no tamponade; both groups were also given intrarectal
or sublingual misoprostol.
Main outcome measure Proportion of women with
invasive surgery or who died before hospital discharge.
Results The proportion of primary composite outcome
did not differ significantly between the tamponade arm
(16%; 9/57) and the standard second line treatment
arm (7%; 4/59): relative risk 2.33 (95% CI 0.76 to 7.14,
p=0.238). A significantly increased proportion of women
with tamponade and misoprostol versus misoprostol alone
had total blood loss more than 1000 mL: relative risk 1.52
(95% CI 1.15 to 2.00, p=0.01). Case fatality rate was
higher in the tamponade group (10%; 6/57) than in the
control group (2%; 1/59) (p=0.059). |
| Mots clés |
Uterine balloon tamponade, misoprostol postpartum haemorrhage |
| Pages |
1 - 10 |
| Fichier |
(PDF) |