Successful management of PPH secondary to complete placenta previa with 2 foley's balloon catheters: A case report

Abstract

Placenta previa is presence of placental tissue over or adjacent to cervical os. Since the lower uterine segment contracts poorly after separation of placenta, it results in excessive post-partum hemorrhage at times. Management options used to control hemorrhage in placenta previa patients include bimanual compression, placental site hemostatic sutures, uterine artery ligation, pelvic artery embolization and emergency hysterectomy. In 1992, Bakri introduced intrauterine balloon tamponade for treatment of obstetric hemorrhage during cesarean delivery. The overall success rate of balloon tamponade in controlling bleeding is 80%. Because of low density of muscle fibers in the lower uterine segment, control of bleeding from open sinuses can be more difficult. A balloon exerting pressure from both sides may be more efficient to control bleeding from lower parts of uterus. There are case reports of use of cervical dilatation double balloon catheter for PPH. Since Bakri Balloon and cervical dilatation double catheter are costly and not readily available in our setup, 2 foleys catheters simultaneously used along with vaginal gauze packing may be an easier alternative. This is a case report of serious PPH in which 2 foleys balloon catheters were simultaneously used to control bleeding.