Evidence map›Paper›PMID 40244365›Full record

ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2025

Cost analysis of intrauterine balloon tamponade versus uterine artery embolization in the management of persistent postpartum hemorrhage.

Lisanne R Bonsen, M Elske van den Akker-van Marle, Camila Caram-Deelder, Paul I Ramler, Christianne J M de Groot, Thijs Urlings, Thomas van den Akker, Johanna G van der Bom, Dacia D C A Henriquez, TeMpOH‐1 study group

Abstract readComparative Study
In one paragraph

Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Cost analysis of intrauterine balloon tamponade versus uterine artery embolization in the management of persistent postpartum hemorrhage.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
    Article
  2. Review
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

10 authors.

Lisanne R BonsenDepartment of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0003-2846-6243
M Elske van den Akker-van MarleDepartment of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands.
Camila Caram-DeelderDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0003-3161-5684
Paul I RamlerDepartment of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0002-9753-3983
Christianne J M de GrootDepartment of Obstetrics and Gynecology, Amsterdam UMC, Universiteit van Amsterdam, Amsterdam, the Netherlands.
Thijs UrlingsDepartment of Radiology, Haaglanden Medical Center, The Hague, the Netherlands.
Thomas van den AkkerDepartment of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0002-9890-9145
Johanna G van der BomDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0001-9095-2475
Dacia D C A HenriquezDepartment of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0003-3164-8611
TeMpOH‐1 study group

Funding

Stichting Sanquin Bloedvoorziening PPOC-11-032
6 · The paper itself

Abstract

objectiveThe aim of this study was to compare the cost of a strategy initially resorting to intrauterine balloon tamponade versus a strategy initially resorting to uterine artery embolization in the management pathway of persistent postpartum hemorrhage.

methodsThis was a propensity score-matched cohort study including women who were subsequently treated with (scenario 1) versus uterine artery embolization (scenario 2) in order to control PPH, defined as postpartum bleeding that was resistant to first-line treatment. We compared these two scenarios in terms of cost. These were based on costs of intervention, blood products transfused, and intensive care unit admission. We calculated the mean cost difference between the scenarios per woman.

resultsThe propensity score-matched cohort comprised 50 women per scenario. In scenario 1, intrauterine balloon tamponade was successful in 29 women (58%), with a mean cost per patient of €7060 (standard deviation [SD], €2846). In scenario 2, uterine artery embolization was successful in 42 women (84%), with mean cost per patient of €7122 (SD, €2918). In each scenario, six women (12%) underwent a peripartum hysterectomy. The difference in mean cost per woman between the two scenarios was €62 in favor of scenario 1.

conclusionThere is a negligible difference in cost between scenarios in which women with PPH are initially managed with intrauterine balloon tamponade versus uterine artery embolization. Given the comparable cost and maternal outcomes, intrauterine balloon tamponade is a favorable treatment, considering its less invasive nature, practical considerations, and lower risk of complications.

Indexed as

Postpartum HemorrhageUterine Artery EmbolizationUterine Balloon TamponadeAdultCohort StudiesCosts and Cost AnalysisFemaleHumansPregnancyPropensity Scorecost analysisintrauterine balloon tamponadematernal morbidityperipartum hysterectomypostpartum hemorrhageuterine artery embolization

Identifiers

PMID40244365
PMCPMC12374024

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Registered trials

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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.