[Active management of postpartum hemorrhage and Bakri balloon placement in primiparous and multiparous].

OBJECTIVE: To evaluate the usefulness of active management of the third stage of labor plus Bakri balloon in primiparous and multiparous. patients with postpartum hemorrhage. MATERIAL AND MET HOD: A retrospective, cross-sectional analytical study in the Hospital of Women, from 1st January 2013 to 31st December 2014. We use uterotonics and after persistence of postpartum hemorrhage also considered Bakri balloon placement, and further transfusion management were evaluated. Analysis descriptive and inferential statistics were performed (Mann-Whitney U and linear regression) and the relationship between inter- and intra-group variables analyzed, a significance level of p <0.05 was established.

RESULTS: We choice 47 patients (26 primiparous and 21 multiparous). The 100% of cases avoids obstetric hysterectomy, average age was lower in primiparous than multiparous (p <0.05). Both groups required transfusion of blood products at similar. The relationship between days of hospitalization vs bleeding volume was directly proportional to primiparous, but inversely proportional to the multiparous (p <0.05), the analysis for combinations of uterotonics in the management of post-partum hemorrhage, shown that misoprostol (800 mg, rectally) stressed this relationship in primiparous while effect disappears in multiparous.

CONCLUSION: The Bakri balloon placement decreases the number of fatalities and hysterectomies in obstetric patients in both primiparous and multiparous with postpartum hemorrhage that does not response to the treatment with .uterotonic drugs.