Successfulness of the Bakri Intrauterine Balloon For Uterotonic-Unresponsive Postpartum Haemorrhage Treatment: Systematic Review and Meta-Analysis.

Abstract

The main purpose of this meta-analysis was to quantify the successfulness of Bakri balloon in managing postpartum haemorrhage (PPH) unresponsive to uterotonics.We performed a literature search using the MEDLINE (accessed via PubMed) database from inception to October 2019, for clinical trials and observational studies. Meta-analysis was performed applicating the random-effects model. Primary outcome was the successfulness of the Bakri balloon in stopping PPH unresponsive to uterotonics. Twenty-eight publications (n=1868 applications of Bakri balloon) matched the inclusion criteria for the meta -analysis. Ten studies referred the incidence of Bakri balloon applications with a 0.335% (1004/299124; 95% CI, 0.2 –0.4%) rate. Success rate of the haemostatic balloon in stopping PPH without requiring other procedures was 82% (1597/1868; 95% CI, 78– 86%), while further procedures were needed for 271 patients (13,83%; 95% CI, 11–21%). Bakri balloon plus additional procedures were effective in the control of the PPH in the 95% of all cases (1645/1868; 95% CI, 93–98%). Hysterectomy was performed in the 5% (78/1597; 95% CI, 2–6%) of all women who needed a Bakri balloon. Bakri balloon represents a successful therapeutic option for blocking PPH when unresponsive to uterot onics.