Efficacy and safety of prophylactic Bakri balloon tamponade after vaginal delivery in women with low-lying placenta: a retrospective cohort study

BACKGROUND: Low-lying placenta is a special form of placenta previa and a major cause of postpartum hemorrhage (PPH). As an important hemostatic tool, the Bakri balloon is widely used in the prevention and treatment of PPH caused by placenta previa. Few studies have paid attention to the effect of Bakri balloon after vaginal delivery in women with low-lying placenta. The aim of this study is to evaluate the efficacy and safety of prophylactic Bakri balloon tamponade (BBT) after vaginal delivery in women with low-lying placenta based on a retrospective cohort study. METHODS: Singleton pregnant women with low-lying placenta who had vaginal deliveries at our hospital between January 2015 to December 2020 were enrolled. Women who received prophylactic balloon tamponade immediately after vaginal delivery were defined as the BBT group, while women who underwent routine procedures after vaginal delivery except immediate balloon tamponade were defined as the non-BBT group. The maternal clinical characteristics and outcomes of the two groups were collected and analyzed retrospectively. RESULTS: A total of 118 women with low-lying placenta were included in the study, with 47 in the BBT group and 71 in the non-BBT group. The postpartum bleeding amount was 339.19±102.94 mL at 2 hours and 418.11±90.73 mL at 24 hours in the BBT group, while in the non-BBT group the postpartum bleeding amount was 421.55±106.37 mL at 2 hours and 505.11±94.51 mL at 24 hours, with significant differences between the two groups (P<0.05). However, there were no significant differences in the postpartum length of hospital stay (P=0.085) and the incidence of puerperal infection (P=0.244) between the two groups. CONCLUSIONS: Routine use of prophylactic BBT after vaginal delivery can significantly reduce the postpartum bleeding amount in women with low-lying placenta and does not increase the incidence of puerperal infection and the postpartum length of hospital stay.