Efficacy of Balloon Tamponade in Post-partum Hemorrhage Within 24 Hours After Delivery (BT-PPH)
Postpartum hemorrhage (PPH) is a major cause of maternal death, especially in developing countries like Pakistan where it accounts for up to 34% of maternal deaths. When bleeding after delivery does not stop with medicines like oxytocin and uterine massage, a low-cost method called balloon tamponade can be life-saving.
This study titled "Efficacy of Balloon Tamponade in Post-partum Hemorrhage within 24 Hours After Delivery" will be conducted by Dr. Maryam Aslam (PGR Gynecology and Obstetrics) under supervision of Prof. Dr. Raheela Farhat at Aziz Fatima Hospital, Faisalabad.
The objective is to determine the efficacy of intrauterine balloon tamponade (condom catheter balloon) in controlling primary PPH. Efficacy is defined as successful control of bleeding within six hours of balloon insertion without need for additional surgery, confirmed by absence of active vaginal bleeding, a contracted uterine fundus, and stable maternal condition after removal of the balloon. The results will help promote a simple, effective procedure that can even be used by primary health care workers to reduce maternal mortality.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a Descriptive Cross-Sectional Study.
Title: Efficacy of Balloon Tamponade in Post-partum Hemorrhage within 24 hours after delivery.
Setting: Department of Obstetrics and Gynecology, Aziz Fatima Hospital, Faisalabad.
Duration: Six months after approval from CPSP. Sample Size: 121 patients, calculated by WHO sample size calculator using anticipated proportion 81%, significance level 5%, margin of error 7%.
Sampling Technique: Consecutive non-probability sampling.
Operational Definitions:
- Postpartum Haemorrhage (PPH): Blood loss of more than 500 ml (one kidney tray) following vaginal delivery and 1000 ml following cesarean section within 24 hours. Estimation by kidney tray method.
- Efficacy: Successful control of PPH within six hours of balloon insertion, without need for additional surgical intervention. Success is confirmed by absence of active vaginal bleeding, contracted uterine fundus, and stable maternal condition following gradual deflation and removal of the balloon device.
Inclusion Criteria:
- Age 18-35 years
- Gestational age between 31 to 41 weeks
- Having primary PPH
Exclusion Criteria:
- Obstetric hemorrhage (Antepartum Hemorrhage) <31 weeks of gestation
- Multiparity (Children more than 5)
- Traumatic PPH (cervical and vaginal tears)
- Allergy to latex
- Acute uterine infection (chorioamnionitis)
- Cases with bleeding disorders, ruptured uterus
- Patient whose PPH is managed successfully with uterine curettage
Data Collection Procedure:
After approval from Institutional Ethical Committee (Ref: IEC/392-25 dated 30/09/2025) and CPSP, and informed consent from patients. Patients meeting inclusion criteria will be selected. A proforma will be used to document demographic data. Women with PPH who do not improve with uterotonics will be evaluated for treatment with condom and Foley catheter balloon. A condom-lined sterile rubber catheter will be inserted into the uterus under strict aseptic technique. The balloon will be placed on cervix and held with roller gauze and sponge-holding forceps. 300-400 ml of regular normal saline will be used to inflate the condom. The catheter condom will be stored for up to six hours. If no active bleeding is detected through the cervix and uterine fundus is felt contracted after 6 hours, balloon will be slowly deflated at rate of 50 ml/hour to half its volume in 2 hours. If no further bleeding occurs during next 30 minutes, balloon will be removed in presence of senior staff member. If bleeding persists or uterine fundus rises, condom tamponade will be abandoned and surgical intervention will be pursued.
Data Analysis:
Data will be entered into SPSS version 25. Mean and standard deviation will be calculated for quantitative variables such as age, gestational age, blood loss. Frequencies and percentages will be used for categorical variables such as socioeconomic status, education status, booking status, parity, mode of delivery and efficacy. Chi-square test will be applied to efficacy. Effect modifiers like age, gestational age, blood loss, socioeconomic status, education status, booking status, parity, mode of delivery will be controlled by stratification. Post-stratification chi-square test will be applied and P-value <0.05 will be considered statistically significant.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Maryam Aslam, MBBS
- Phone Number: 03038059729
- Email: aslammaryam18@gmail.com
Study Locations
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Punjab Province
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Faisalābad, Punjab Province, Pakistan, 38000
- Aziz Fatima hospital
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Contact:
- Maryam Aslam, MBBS
- Phone Number: 03038059729
- Email: aslammaryam18@gmail.com
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Women aged 18-35 years with gestational age 31-41 weeks presenting with primary postpartum hemorrhage unresponsive to medical management at Department of Obstetrics and Gynaecology, Allied Hospital Faisalabad. Total 121 participants selected via consecutive non-probability sampling as per WHO sample size calculator with 7% margin of error.
Description
Inclusion Criteria:
- Age 18-35 years
- Having gestational age between 31 to 41 weeks
- Having PPH (Primary postpartum hemorrhage unresponsive to uterotonics)
Exclusion Criteria:
- Patient who has Obstetric hemorrhage (Antepartum Hemorrhage) <31 weeks of gestation
- Multiparity (Children more than 5)
- Traumatic PPH (cervical and vaginal tears)
- Allergy to latex
- Acute uterine infection (chorioamnionitis)
- Cases with bleeding disorders, ruptured uterus
- Patient whose postpartum hemorrhage is managed successfully with uterine curettage
Study Plan
How is the study designed?
Design Details
- Observational Models: OTHER
- Time Perspectives: CROSS_SECTIONAL
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
|
This cohort includes 121 women aged 18-35 years with gestational age 31-41 weeks who developed prima
A condom-lined sterile rubber catheter will be inserted into the uterus under strict aseptic conditions. Balloon placed on cervix and held with roller gauze and sponge-holding forceps. Balloon inflated with 300-400 ml of regular normal saline and kept for up to six hours. If no active bleeding detected through cervix and uterine fundus felt contracted after 6 hours, balloon will be slowly deflated at rate of 50 ml/hour to half its volume in 2 hours. If no further bleeding during next 30 minutes, balloon removed in presence of senior staff. If bleeding persists or fundus rises, tamponade abandoned and surgical intervention pursued. Efficacy defined as successful control of PPH within six hours of insertion without need for additional surgery, confirmed by absence of active vaginal bleeding, contracted uterine fundus and stable maternal condition. |
Condom-lined sterile rubber catheter inserted into uterus under aseptic technique, held with roller gauze and sponge-holding forceps. Balloon inflated with 300-400 ml normal saline and kept up to 6 hours. If no active bleeding and uterine fundus contracted after 6 hours, balloon deflated at 50 ml/hour to half volume in 2 hours then removed if no bleeding in next 30 min in presence of senior staff. If bleeding persists, tamponade abandoned and surgical intervention pursued. Efficacy is successful control of PPH within 6 hours without additional surgery, confirmed by absence of active vaginal bleeding, contracted fundus and stable maternal condition. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Efficacy of intrauterine condom catheter balloon tamponade in control of primary postpartum hemorrhage
Time Frame: Within 6 hours of intervention and assessed for 30 minutes after deflation
|
Efficacy is defined as successful control of primary PPH within 6 hours of balloon insertion without need for additional surgical intervention. Success confirmed by absence of active vaginal bleeding, contracted uterine fundus on abdominal palpation and stable maternal vital signs and general condition. Failure defined as persistent bleeding or rising fundus requiring surgical intervention. |
Within 6 hours of intervention and assessed for 30 minutes after deflation
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- AFH-OBG-PPH-2026
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Individual participant data will not be shared due to institutional ethical restrictions and confidentiality of this academic dissertation project at Aziz Fatimah Hospital Faisalabad.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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