Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica

IMPACT FACTOR 2018: 1.361
5-year IMPACT FACTOR: 1.578

CiteScore 2018: 1.29

SCImago Journal Rank (SJR) 2018: 0.522
Source Normalized Impact per Paper (SNIP) 2018: 0.602

See all formats and pricing
More options …
Volume 46, Issue 1


Serum fibrinogen levels could be an index of successful use of balloon tamponade in postpartum hemorrhage

Ayaka Nakashima
  • Department of Obstetrics and Gynecology, Rinku General Medical Center Senshu Regional Medical Center for Women and Children’s Health, Izumisano-shi, Osaka, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Kazuhide Ogita
  • Corresponding author
  • Department of Obstetrics and Gynecology, Rinku General Medical Center Senshu Regional Medical Center for Women and Children’s Health, Rinku Ourai Kita 2-23, Izumisano-shi, Osaka 598-8577, Japan, Phone: +81-72-469-3111, Fax: +81-72-469-7929
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Masaya Chita
  • Department of Obstetrics and Gynecology, Saitama Red Cross Hospital, Chuo-ku, Saitama-shi, Saitama, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Takeshi Yokoi
  • Department of Obstetrics and Gynecology, Kaizuka City Hospital Senshu Regional Medical Center for Women and Children’s Health, Kaizuka-shi, Osaka, Japan
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-02-28 | DOI: https://doi.org/10.1515/jpm-2016-0238



The object of our study was to determine whether serum fibrinogen levels could be used to predict the success rates of balloon tamponade and decrease the use of invasive methods.


This retrospective study, conducted at Rinku General Medical Center, was aimed to identify factors associated with high success rates in balloon tamponade. Forty-six patients with postpartum hemorrhage (PPH), non-responsive to uterotonics and treated with balloon tamponade between April 2008 and March 2015, were included.


Forty-six women were included, of which 34 underwent vaginal delivery and 12 underwent cesarean delivery. There were no complications from balloon tamponade and its success rate was 73.3%. Seven women required additional procedures: One used gauze packing, three used uterine artery embolization, and five underwent peripartum hysterectomy. The cut-off line of serum fibrinogen level was 172.5 mg/dL (P=0.002) with its 77.4% sensitivity and 66.7% specificity.


We recommend measuring serum fibrinogen level for predicting whether the balloon tamponade can be used successfully or not.

Keywords: Balloon tamponade; fibrinogen; postpartum hemorrhage


  • [1]

    World Health Organization Attending to 136 million births, every year: make every mother and child count: the World Health Report, 2005, 62–63. World Health Organization, Geneva.Google Scholar

  • [2]

    Ford JB, Roberts CL, Simpson JM, Vaughan J, Cameron CA. Increased postpartum hemorrhage rates in Australia. Int J Gynaecol Obstet. 2007;98:237–43.PubMedCrossrefGoogle Scholar

  • [3]

    AbouZahr C. Global burden of maternal death and disability. Br Med Bull. 2003;67:1–11.PubMedCrossrefGoogle Scholar

  • [4]

    Hoyert DL. Maternal mortality and related concepts. Vital Health Stat. 2007;3:1–13.Google Scholar

  • [5]

    Postpartum hemorrhage. ACOG Practive Bulletin No.76. American College of Ostetricians and Gyneologists. Obstet Gynecol. 2006;108:1039–47.Google Scholar

  • [6]

    Pritchard JA. Blood volume changes in pregnancy and the puerperium. Red blood cell loss and changes in apparent blood volume during and following vaginal delivery, cesarean section, and cesarean section plus total hysterectomy. Am J Obstet Gynecol. 1962;84:1271.Google Scholar

  • [7]

    Clark SL, Yeh SY, Phelan JP, Bruce S, Paul RH. Emergency hysterectomy for obstetric hemorrhage. Obstet Gynecol. 1984;64:376–80.PubMedGoogle Scholar

  • [8]

    McLintock C, James AH. Obstetric hemorrhage. J Thromb Haemost. 2011;9:1441–51.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [9]

    Bonnar J. Massive obstetric haemorrhage. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14:1–18.CrossrefPubMedGoogle Scholar

  • [10]

    Charbit B, Mandelbrot L, Samain E, Baron G, Haddaoui B, Keita H, et al. The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage. J Thromb Haemost. 2007;5:266–73.CrossrefWeb of SciencePubMedGoogle Scholar

  • [11]

    Dabelea V, Schultze PM, McDuffie RS. Intrauterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol. 2007;24:359–64.CrossrefWeb of SciencePubMedGoogle Scholar

  • [12]

    Vitthala S, Tsoumpou I, Anjum ZK, Aziz NA. Use of Bakri balloon in postpartum haemorrhage; a series of 15 cases. Aust NZ J Obstet Gynaecol. 2009;49:191–4.CrossrefGoogle Scholar

  • [13]

    Diemert A, Ortmeyer G, Hollwitz B, Lotz M, Somville T, Glosemeyer P, et al. The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage. Am J Obstet Gynecol. 2012;206:65.e1–4.Web of ScienceCrossrefGoogle Scholar

  • [14]

    Aibar L, Aguilar MT, Puertas A, Valverde M. Bakri balloon for the management of postpartum hemorrhage. Acta Obstet Gynecol Scand. 2013;92:465–7.CrossrefWeb of SciencePubMedGoogle Scholar

  • [15]

    Grönvall M, Tikkanen M, Tallberg E, Paavonen J, Stefanovic V. Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: a series of 50 cases from a tertiary teaching hospital. Acta Obstet Gynecol Scand. 2013;92:433–8.CrossrefPubMedGoogle Scholar

  • [16]

    Olsen R, Reisner DP, Benedetti TJ, Dunsmoor-Su RF. Bakri balloon effectiveness for postpartum hemorrhage: a “real world” experience. J Matern Fetal Neonatal Med. 2013;26:1720–3.CrossrefWeb of SciencePubMedGoogle Scholar

  • [17]

    Vrachnis N, Salakos N, Iavazzo C, Grigoriadis C, Iliodromiti Z, Siristatidis C, et al. Bakri balloon tamponade for the management of postpartum hemorrhage. Int J Gynaecol Obstet. 2013;122:265–6.PubMedCrossrefGoogle Scholar

  • [18]

    Kaya B, Tuten A, Daglar K, Misirlioglu M, Polat M, Yildirim Y, et al. Balloon tamponade for the management of postpartum uterine hemorrhage. J Perinat Med. 2014;42:745–53.Web of SciencePubMedGoogle Scholar

  • [19]

    Vintejoux E. Success factors for Bakri balloon usage secondary to uterine atony: a retrospective, multicenter study. Aust NZ J Obstet Gynaecol. 2015;55:572–7.CrossrefGoogle Scholar

  • [20]

    Yamamoto K. Underlying mechanisms of transfusion therapy for obstetric massive hemorrhage. Jpn J Transfus Cell Ther. 2012;58:745–52.CrossrefGoogle Scholar

  • [21]

    Al-Zirqi I, Vangen S, Forsen L, Stray-Pedersen B. Prevalence and risk factors of severe obstetric haemorrhage. Br J Obstet Gynaecol. 2008;115:1265–72.CrossrefGoogle Scholar

  • [22]

    O’Shaughnessy DF, Atterbury C, Bolton MP, Murphy M, Thomas D, Yates S, et al. Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol. 2004;126:11–28.Web of ScienceCrossrefGoogle Scholar

  • [23]

    Kozek-Langenecker SA, Afshari A, Albaladejo P, Santullano CA, De Robertis E, Filipescu DC, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2013;30:270–382.PubMedCrossrefGoogle Scholar

About the article

Received: 2016-07-15

Accepted: 2017-01-23

Published Online: 2017-02-28

Published in Print: 2018-01-26

Author’s statement

Conflict of interest: Authors state no conflict of interest.

Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

Citation Information: Journal of Perinatal Medicine, Volume 46, Issue 1, Pages 53–57, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2016-0238.

Export Citation

©2018 Walter de Gruyter GmbH, Berlin/Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Nassir Habib, Dominique Luton, Gabriele Centini, Isabelle Renuit, Christian Birbarah, and Pierre-François Ceccaldi
Journal of Investigative Surgery, 2019, Page 1

Comments (0)

Please log in or register to comment.
Log in