Özet:

Objective: Uterine atony is one of the serious complications of labour. Hysterectomy is mostly required in acute cases. Conservative management with intrauterine balloon insertion alone or in combination with B-Lynch suture might be an alternative. We report a case series from a referral hospital. Material and Method: This was a retrospective analysis of 30 postpartum uterine atony cases refractory to uterotonic treatment and managed with intrauterine balloon tamponade with or without B-Lynch suture. Results: Thirty cases managed with intrauterine Bakri balloon tamponade (BBT) with or without B-Lynch compression suture. Our success rate was 86 %. Median estimated blood loss was 1850 ml, intraoperative median hemoglobin was 6.6 mg/dl, median amount of blood transfused was four units, median operation duration was 70 minutes, median volume infused into balloon was 250 ml, balloon was in place for a median duration of 30 hours. In 4 cases Bakri balloon tamponade with or without B-Lynch compression sutures failed to stop hemorrhage and hysterectomy required. In one patient Asherman’s syndrome and infertility developed. In cases which BBT was successful PI values of bilateral uterine artery doppler was similar to control group. There wasn’t maternal mortality. Conclusion: Balloon tamponade of uterus with or without compression sutures is an effective, quick, simple and fertility preserving technique in the management of postpartum uterine atony bleeding. It further provides time for more complicated interventions in case of failure to control hemor-rhage.

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