What is it about?

A total of 19 patients were included in the case series. Twelve patients were managed in district hospitals and 7 in the central hospital. Ten patients, managed in district hospitals, were transferred to the central hospital. The bleeding reduced from torrential blood loss to a trickle in 15 patients, reduced in amount in 1 and had no effect on bleeding in 3 (2 with uterine tears). One of the 15 patients required Ellavi following insertion of B-Lynch sutures. All patients were discharged home in good health.

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Why is it important?

1. The Ellavi UBT is a device that is an open system and allows water to be expelled from the balloon to reduce the volume and allow the physiological process of contraction and retraction of the myometrium to occur. 2. The rapid filling of the uterine balloon allows a quick assessment of the effect of the Ellavi UBT. The mechanism of action of Ellavi UBT is the application of pressure against the bleeding sinusoids in the placental implantation site. If this pressure equals the systolic arterial pressure a tamponade effect will be created. 3. Cases with uterine necrosis with uterine ballon use following insertion of compression sutures have been reported. Using a UBT once compression sutures have been inserted, requires pressure control. The Ellavi UBT allows intra-uterine pressure control by adjusting the height of the supply bag above the patient.

Perspectives

The device has unique features and is affordable for use in lesser resourced countries.

Gerhard Theron
Stellenbosch University

Read the Original

This page is a summary of: Management of postpartum hemorrhage with free-flow pressure controlled uterine balloon, International Journal of Gynecology & Obstetrics, June 2018, Wiley,
DOI: 10.1002/ijgo.12533.
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