Evidence map›Paper›PMID 30365539›Full record

ArticlePloS one2018

Predictors of failed intrauterine balloon tamponade for persistent postpartum hemorrhage after vaginal delivery.

Joséphine Grange, Manon Chatellier, Marie-Thérèse Chevé, Anne Paumier, Claudine Launay-Bourillon, Guillaume Legendre, Marion Olivier, Guillaume Ducarme

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In one paragraph

Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Joséphine GrangeDepartment of Obstetrics and Gynecology, Centre Hospitalier Départemental, La Roche sur Yon, France.
Manon ChatellierRéseau Sécurité Naissance des Pays de la Loire, Nantes, France.
Marie-Thérèse ChevéDepartment of Obstetrics and Gynecology, Le Mans General Hospital, Le Mans, France.
Anne PaumierDepartment of Obstetrics and Gynecology, Atlantic Polyclinic, Saint-Herblain, France.
Claudine Launay-BourillonDepartment of Obstetrics and Gynecology, Jules Verne Clinic, Nantes, France.
Guillaume LegendreDepartment of Obstetrics and Gynecology, Angers University Hospital, Angers, France.
Marion OlivierRéseau Sécurité Naissance des Pays de la Loire, Nantes, France.
Guillaume DucarmeDepartment of Obstetrics and Gynecology, Centre Hospitalier Départemental, La Roche sur Yon, France.ORCID 0000-0002-2549-353X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify the predictors of intrauterine balloon tamponade (IUBT) failure for persistent postpartum hemorrhage (PPH) after vaginal delivery.

designRetrospective case-series in five maternity units in a perinatal network.

settingAll women who underwent IUBT for persistent PPH after vaginal delivery from January 2011 to December 2015 in these hospitals.

methodsAll maternity apply the same management policy for PPH. IUBT, using a Bakri balloon, was used as a second line therapy for persistent PPH after failure of bimanual uterine massage and uterotonics to stop bleeding after vaginal delivery. Women who required another second line therapy (embolization or surgical procedures) to stop bleeding after IUBT were defined as cases, and women whom IUBT stopped bleeding were defined as control group. We determined independent predictors for failed IUBT using multiple regression and adjusting for demographics with adjusted odds ratios (aORs) and 95% confidence intervals (95% CI).

resultsDuring the study period, there were 91,880 deliveries in the five hospitals and IUBT was used in 108 women to control bleeding. The success rate was 74.1% (80/108). In 28 women, invasive procedures were required (19 embolization and 9 surgical procedures with 5 peripartum hysterectomies). Women with failed IUBT were more often obese (25.9% vs. 8.1%; p = 0.03), duration of labor was shorter (363.9 min vs. 549.7min; p = 0.04), and major PPH (≥1,500 mL) before IUBT was more frequent (64% vs. 40%; p = 0.04). Obesity was a predictive factor of failed IUBT (aOR 4.40, 95% CI 1.06-18.31). Major PPH before IUBT seemed to be another predictor of failure (aOR 1.001, 95% CI 1.000-1.002), but our result did not reach statistical significativity.

conclusionIntrauterine balloon tamponade is an effective second line therapy for persistent primary PPH after vaginal delivery. Pre-pregnancy obesity is a risk factor of IUBT failure.

Indexed as

Delivery, ObstetricFemaleHumansHysterectomyParturitionPostpartum HemorrhageRetrospective StudiesRisk FactorsUterine Balloon Tamponade

Identifiers

PMID30365539
PMCPMC6203390

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.