A comparative study of safety and efficacy of prophylactic insertion of Dr.burke’s every second matters-uterine balloon tamponade (esm-ubt) with i.m oxytocin vs only i.m oxytocin for prevention of atonic pph in women.

Abstract

Background: Postpartum hemorrhage (PPH) remains a main cause of maternal mortality in the world, specially in low-resource settings. Uterine atony, the most common cause of PPH, often requires rapid and effective management to prevent life-threatening complications. While intramuscular (IM) oxytocin is the first-line intervention, cases unresponsive to uterotonics necessitate additional measures. Uterine balloon tamponade (UBT) has emerged as a minimally invasive and cost-effective technique for managing atonic PPH. This study evaluates the safety and efficacy of prophylactic use of Dr. Burke’s Every Second Matters-Uterine Balloon Tamponade (ESM-UBT) combined with IM oxytocin versus IM oxytocin alone in preventing atonic PPH among women at high risk. Methods: This randomized parallel-group trial was conducted over 1.5 years at Shri B.M. Patil Medical College, Hospital, and Research Centre, Vijayapura. A total of 226 women with high-risk pregnancies for atonic PPH were enrolled and randomized into two groups: Group 1 received prophylactic ESM-UBT with IM oxytocin (10 units), while Group 2 received only IM oxytocin. Blood loss was measured using the BRASS V drape and additional gauze pad weight assessment. Hemoglobin levels were recorded pre-delivery and 48 hours postpartum. Analysis was performed using a software SPSS version 20. Results: The prophylactic use of ESM-UBT significantly reduced total blood loss (median: 120 mL vs. 320 mL, p < 0.01) and post-delivery hemoglobin drop (Group 1: 9.9 g/dL vs. Group 2: 9.2 g/dL, p = 0.0049). Blood loss at 5, 10, and 60 minutes postpartum was consistently lower in the ESM-UBT group (p < 0.0001). The requirement for additional uterotonics and blood transfusion was significantly higher in the IM oxytocin-only group (p = 0.002, p = 0.013, respectively). Conclusion: Prophylactic ESM-UBT significantly reduces blood loss and the need for additional interventions in high-risk women, demonstrating its potential as a vital tool in PPH prevention, particularly in resource-limited settings. Its cost-effectiveness and ease of use make it a feasible solution for improving maternal outcomes globally.