Safety and efficacy of the initial application of vacuum-induced intrauterine tamponade for the management of postpartum hemorrhage

This study aimed to evaluate the safety and efficacy of vacuum-induced intrauterine balloon tamponade (vIBT) using the modified Bakri system in a clinical setting. This single-center observational study included women who had undergone vIBT for primary postpartum hemorrhage (PPH). Vacuum induction at 60 kPa in the uterus was continued for 1 h with 50–100 ml saline, and the balloon was promptly removed after the protocol was completed. PPH was defined as an estimated blood loss of 1000 ml or more at delivery and sustained bleeding of ≥100 ml/h after delivery. The primary and secondary endpoints were the safety and efficacy of vIBT. The criteria for PPH were met in 28 out of 601 (4.3 %) patients, 20 of whom underwent vIBT. No adverse events directly related to vIBT, such as uterine perforation, anaphylaxis, or endometritis, were observed. No patients were unable to undergo vIBT due to intrauterine balloon expulsion. It was successful in 19 out of 20 (95 %) patients. Blood transfusion was required in 6 out of 20 (30 %) patients. VIBT was safe and easy to perform in most patients with PPH, achieving effective bleeding control.