Early Usage of Bakri Ballon in Managing Postpartum Hemorrhage

NCT ID: NCT02861482

Last Updated: 2016-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

472 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-01-31

Study Completion Date

2016-03-31

Brief Summary

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Postpartum hemorrhage (PPH) is the top reason for maternal deaths in China. The four major causes of PPH include uterine atony, genital tract laceration, placenta factors and systemic medical disorders (including inherited and acquired coagulopathy). Management of PPH contains the application of uterotonic agents, using hemostasis agents, transfusion of blood component products, conservative procedures (intrauterine packing or balloon tamponade, compression sutures, vascular ligation and uterine artery embolization using sponges), and even hysterectomy.

The Bakri Balloon has attained its efficacy and popularity ever since it was invented by Doctor YN. Bakri. Although it is recommended by many countries as a routine procedure for PPH management, the Bakri Balloon is not yet a first choice in China due to lack in clinical data of preventive usage.

The aim of this study is to prove the efficacy and safety of the Bakri Balloon in early management of PPH.

Detailed Description

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Data of 472 patients from 20 different hospitals had a Bakri balloon tamponade. Enrolled patients would follow the next process: assessment of blood loss intrapartum and 2 hours postpartum; laying the Bakri Balloon; assessment of blood loss, uterine contraction and complications after Bakri Balloon tamponade; further conservative surgical measures (uterine placation (B-lynch suture), arterial embolization; artery ligation; cervical cerclage) or even hysterectomy if necessary; recording the puerperium infection and involution of uterus.

Data were analyzed by SPSS 20.0 database. The results were expressed as mean ± standard deviations or median with interquartile range. Differences between groups were assessed by Student's unpaired t test, Mann-Whitney U test, or Chi-square test as appropriate. Correlation analysis was performed using the Spearman rank correlation method. To identify independent relationships and adjust the effects of covariates, multiple linear regression analyses were performed. P values of \<0.05 were considered significant.

Conditions

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Postpartum Hemorrhage

Keywords

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PPH, Bakri Ballon

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Bakri Ballon

All the enrolled patients who would undergo the laying of Bakri Balloon

Group Type EXPERIMENTAL

Bakri Balloon

Intervention Type DEVICE

Gradually increase the liquid volume inside Bakri Balloon to 250-500ml until bleeding is decreased or stopped

Oxytocin

Intervention Type DRUG

using oxytocin(usage:20IU oxytocin in 500ml lactated Ringer's, ivgtt to a maximum of 60IU) for the first step when dealing with PPH before laying Bakri Balloon

Hemabate

Intervention Type DRUG

using Hemabate (usage:250-500ug im) for the first step when dealing with PPH before laying Bakri Balloon

Duratocin

Intervention Type DRUG

using Duratocin (usage:100ug iv) for the first step when dealing with PPH before laying Bakri Balloon

Uterine Massage

Intervention Type PROCEDURE

continuous uterine massage for the first step when dealing with PPH before laying Bakri Balloon

B-lynch Suture

Intervention Type PROCEDURE

One of conservative surgical procedures if Bakri Balloon didn't work

Uterine Artery Embolization using sponges

Intervention Type PROCEDURE

One of conservative surgical procedures if Bakri Balloon didn't work

Cervical cerclage

Intervention Type PROCEDURE

One of conservative surgical procedures if Bakri Balloon didn't work

Hysterectomy

Intervention Type PROCEDURE

Hysterectomy with all the above measures not working

Blood Product

Intervention Type DRUG

transfusion of blood product if necessary no matter which surgical procedure has been taken

Interventions

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Bakri Balloon

Gradually increase the liquid volume inside Bakri Balloon to 250-500ml until bleeding is decreased or stopped

Intervention Type DEVICE

Oxytocin

using oxytocin(usage:20IU oxytocin in 500ml lactated Ringer's, ivgtt to a maximum of 60IU) for the first step when dealing with PPH before laying Bakri Balloon

Intervention Type DRUG

Hemabate

using Hemabate (usage:250-500ug im) for the first step when dealing with PPH before laying Bakri Balloon

Intervention Type DRUG

Duratocin

using Duratocin (usage:100ug iv) for the first step when dealing with PPH before laying Bakri Balloon

Intervention Type DRUG

Uterine Massage

continuous uterine massage for the first step when dealing with PPH before laying Bakri Balloon

Intervention Type PROCEDURE

B-lynch Suture

One of conservative surgical procedures if Bakri Balloon didn't work

Intervention Type PROCEDURE

Uterine Artery Embolization using sponges

One of conservative surgical procedures if Bakri Balloon didn't work

Intervention Type PROCEDURE

Cervical cerclage

One of conservative surgical procedures if Bakri Balloon didn't work

Intervention Type PROCEDURE

Hysterectomy

Hysterectomy with all the above measures not working

Intervention Type PROCEDURE

Blood Product

transfusion of blood product if necessary no matter which surgical procedure has been taken

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Women with vaginal or cesarean delivery;
* PPH caused by: Uterine Atony, Placenta Factors, Coagulation disorders, Hematological disorders, Hepatic diseases, Obstetric DIC;
* Not reacting well to continuous uterine massage or uterotonic agents including oxytocin (0.04IU/L ivgtt to a maximum of 60IU), Hemabate (250-500ug im) and Duratocin (100ug iv);

* Without other conservative surgical treatment(uterine compression suture, internal arterial embolism; vascular ligation);
* Signing the informed consents;

Exclusion Criteria

* Has undergone or will undergo conservative surgical treatment(uterine compression suture, international arterial embolism; artery ligation);
* Impaired soft birth canal injury;
* Untreated uterine deformity;
* Definite indication for uterectomy.
Minimum Eligible Age

19 Years

Maximum Eligible Age

47 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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First Affiliated Hospital, Sun Yat-Sen University

OTHER

Sponsor Role collaborator

Third Affiliated Hospital, Sun Yat-Sen University

OTHER

Sponsor Role collaborator

Sixth Affiliated Hospital, Sun Yat-sen University

OTHER

Sponsor Role collaborator

The Third Affiliated Hospital of Guangzhou Medical University

OTHER

Sponsor Role collaborator

Guangzhou Women and Children's Medical Center

OTHER

Sponsor Role collaborator

Huadu District People's Hospital of Guangzhou

OTHER

Sponsor Role collaborator

Shenzhen Maternity & Child Healthcare Hospital

OTHER

Sponsor Role collaborator

Dongguan Maternity & Child Health Hospital

UNKNOWN

Sponsor Role collaborator

Zhuhai Maternity & Child Healthcare Hospital

UNKNOWN

Sponsor Role collaborator

The First Maternity & Child Healthcare Hospital of Huizhou

UNKNOWN

Sponsor Role collaborator

Nanhai Women's and Children's Hospital

UNKNOWN

Sponsor Role collaborator

Jiangmen Maternity & Child Health Care Hospital

UNKNOWN

Sponsor Role collaborator

The Third Affiliated Hospital of Southern Medical University

OTHER_GOV

Sponsor Role collaborator

Southern Medical University, China

OTHER

Sponsor Role collaborator

Zhongshan Dongsheng hospital

UNKNOWN

Sponsor Role collaborator

Xiaolan People's Hospital of Zhongshan

UNKNOWN

Sponsor Role collaborator

The First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine

OTHER

Sponsor Role collaborator

Baoan District People's Hospital of Shenzhen

UNKNOWN

Sponsor Role collaborator

Zengcheng District People's Hospital of Guangzhou

UNKNOWN

Sponsor Role collaborator

Dongyu Wang

OTHER

Sponsor Role lead

Responsible Party

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Dongyu Wang

M.D.

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Zilian Wang, M.D.,PhD

Role: STUDY_DIRECTOR

Obstetrics and Gynechology Department of the 1st affiliated hospital of Sun Yat-sen University

Locations

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Obstetrics and Gynechology Department of the 1st affiliated hospital of Sun Yat-sen University

Guangzhou, Guangdong, China

Site Status

Countries

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China

Other Identifiers

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2015COOK

Identifier Type: -

Identifier Source: org_study_id