Management of postpartum haemorrhage using “vacuum hemastop” technology

• Sergey V. Apresyan
• Igor N. Kostin
• Arina A. Karasova
• Artеm O. Lugovoy
• Victor E. Radzinsky

Abstract

Postpartum hemorrhage as a cause of maternal mortality consistently occupies a leading place in the world (27.1%, 3/4 of them are postpartum) and leads the so-called “big five” causes of maternal mortality. In cases of severe postpartum hemorrhage, most deaths occur within 2–4 hours: 140 thousand women in the world die from bleeding annually, of which 75–90% (88% according to WHO) are due to hypotension/atony of the uterus. At the same time, the improvement of balloon tamponade became possible after the availability of modern synthetic materials, which made it possible to revive the method proposed in the 60s of the last centuries by N.H. Pirumov to stop postpartum hemorrhage, based on the creation of negative pressure in the uterine cavity.

Material and methods. The article presents clinical cases of postpartum hemorrhage arrest and a description of the “vacuum hemastop” technique using a uterine collector balloon catheter.

Conclusion. Management of postpartum hemorrhage using a uterine collector balloon catheter, which allows the implementation of “vacuum hemastop” technology, is a quick, simple and effective way to treat postpartum uterine bleeding.

Keywords:postpartum hemorrhage; balloon tamponade; “vacuum hemastop”; uterine collector balloon catheter

REFERENCES

1. Bláha J., Bartošová T. Epidemiology and definition of PPH worldwide. Best Pract Res Clin Anaesthesiol. 2022; 36 (3–4): 325–39.

2. Filippov O.S., Guseva E.V. Maternal mortality in the Russian Federation in 2020: the first year of the pandemic. Problemy reproduktsii [Problems of Reproduction]. 2022; 28 (1): 8–28. DOI: https://doi.org/10.17116/repro2022280118

(in Russian)

3. Rocha Filho E.A., Costa M.L., Cecatti J.G., Parpinelli M.A., Haddad S.M., Pacagnella R.C., et al. Severe maternal morbidity and near miss due to postpartum hemorrhage in a national multicenter surveillance study. Int J Gynaecol Obstet. 2015; 128 (2): 131–6.

4. Filippi V., Chou D., Ronsmans C., et al. Levels and causes of maternal mortality and morbidity. In: R.E. Black, R. Laxminarayan, M. Temmerman, et al. (eds). Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities. 3rd ed. Vol. 2. Washington, DC: The International Bank for Reconstruction and Development/The World Bank, 2016; Chap. 3.

5. Korb D., Lopez R., Hörlin A.L., Schmitz T., Borie C., Sibony O. Effectiveness of prophylactic carbetocin versus oxytocin following vaginal delivery for preventing severe postpartum hemorrhage. Int J Gynecol Obstet. 2023; 162 (3): 889–94.

6. Wilbeck J., Hoffman J.W., Schorn M.N. Postpartum hemorrhage: emergency management for uncontrolled vaginal bleeding. Adv Emerg Nurs J. 2022; 44 (3): 213–9.

7. Umashankar K.M., Dharmavijaya M.N., Sudha R., Sujatha N.D., Kavitha G. Effect of a primary postpartum haemorrhage on the «near-miss» morbidity and mortality at a tertiary care hospital in rural bangalore, India. J Clin Diagn Res. 2013; 7 (6): 1114–9. DOI: https://doi.org/10.7860/JCDR/2013/5376.3066

8. Lomova N.A., Kan N.E., Tyutyunnik V.L., Baev O.R. Balloon tamponade in the treatment protocol for postpartum hemorrhage. Praktika [Practice]. 2015; 1 (1): 10–1. (in Russian)

9. Chandraharan E., Arulkumaran S. Management algorithm for atonic postpartum haemorrhage and management of coagulopathy. Obstet Gynaecol Reprod Med. 2007; 17 (4): 119–22.

10. Barinov S.V., Di Renzo G.C. A new technique to preserve the uterus in patients with placenta accreta spectrum disorders. Am J Obstet Gynecol. 2023; August 23.

11. Prevention and management of postpartum haemorrhage. RCOG. Green-top Guideline No. 52. May 2019: 24 р.

12. Pirumov N.Kh. Copyright certificate for the invention «Device for stopping postpartum uterine bleeding» No. 187224. Committee for Inventions and Discoveries under the Council of Ministers of the USSR. 03.10.1966. (in Russian)

13. Stopping hypo- and atonic uterine bleeding using vacuum metrohemostasis. Methodological recommendations. Approved by the Ministry of Health of the Armenian SSR on April 28, 1983. Yerevan, 1983: 11 p. (in Russian)

14. Haslinger C., Weber K., Zimmermann R. Vacuum-induced tamponade for treatment of postpartum hemorrhage. Obstet Gynecol. 2021; 138 (3): 361–5.

15. D’Alton M.E., Rood K.M., Smid M.C., Simhan H.N., Skupski D.W., Subramaniam A., et al. Intrauterine vacuum-induced hemorrhage-control device for rapid treatment of postpartum hemorrhage. Obstet Gynecol. 2020; 136 (5): 882–91.

16. Escobar M.F., Nassar A.H., Theron G., Barnea E.R., Nicholson W., Ramasauskaite D., et al.; FIGO Safe Motherhood and Newborn Health Committee. FIGO recommendations on the management of postpartum hemorrhage 2022. Int J Gynaecol Obstet. 2022; 157 (suppl 1): 3–50.

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)