Condom-catheter tamponade for the treatment of postpartum haemorrhage and factors associated with success: a prospective observational study

Abstract

Objective: To determine the outcomes and factors associated with postpartum haemorrhage (PPH) treatment with condom-catheter uterine balloon tamponade (C-UBT). Design: Prospective observational study. Setting: A secondary healthcare facility in Nigeria. Population: Women with PPH refractory to first-line treatment. Methods: Demographic and clinical characteristics were compared in women with successful and unsuccessful treatment. Univariate and multivariate logistic regression analyses were used to examine the association of these characteristics with successful treatment. Main outcome measures: The success rate of C-UBT, factors associated with success, and maternal morbidity rates in both successful and unsuccessful treatment groups. Results: Overall, 203/229 (88.6%) women had successful treatment. Women with successful treatment had lower mean blood loss (1248.8 ± 701.3 ml versus 3434.6 ± 906.6 ml; P < 0.0001), lower occurrence of blood transfusion [139 (68.5%) versus 26 (100%); P < 0.0001], lower intensive care unit admission rates [5 (2.5%) versus 20 (76.9%); P < 0.0001], and lower occurrence of infectious morbidities [3 (1.5%) versus 7 (26.9%); P < 0.0001]. In the regression model with two factors, caesarean section (adjusted odds ratio, aOR 0.17; 95% confidence interval, 95% CI 0.07–0.40) was associated with lower success rates compared with vaginal delivery. In the regression model with three factors, advanced maternal age (aOR 0.31; 95% CI 0.11–0.90) and caesarean section (aOR 0.17; 95% CI 0.07–0.41) were associated with lower success rates in comparison with younger maternal age and vaginal delivery, respectively. Conclusions: Second-line PPH treatment with C-UBT is effective, and is associated with low maternal morbidity rates. Advanced maternal age and caesarean section are associated with lower success rates. Tweetable abstract: Condom-catheter tamponade is a useful second-line treatment modality for intractable postpartum haemorrhage.