Comparison of efficacy of surgical interventions (balloon tamponade versus b--lynch suture) to prevent postpartum hemorrhage in patients with placenta previa – a randomized controlled trial

Objective: To compare mean blood loss by prophylactic balloon tamponade versus B-lynch suture in patients with placenta previa. Study Design: Randomized controlled trial (Clinicaltrials.gov: NCT05133167). Place and Duration of Study: Obstetrics and Gynecology Department, Combined Military Hospital, Jhelum Pakistan, from Apr to Oct 2021. Methodology: A total of 60 patients with placenta previa, ranging in age from 18 to 40, were included in the study. Computer-generated random sample allocation was used to assign equal number of patients to Groups A and B. In Group-A, balloon tamponade (using Foley catheter 28 Fr) was used intra-operatively to prevent post-partum hemorrhage. Post-operative blood loss within first 24 hours was estimated by measuring the amount of blood collected in Foley balloon tamponade bag, in milliliters. In Group-B, B-lynch suture was used intra-operatively to prevent post-partum hemorrhage. Post-operative blood loss within first 24 hours was estimated by the weight difference of the pads before and after being used by the patient. Results: The mean blood loss in Group-A (prophylactic balloon tamponade) was 118.97±20.26 ml, while it was 154.13±15.21 ml in Group-B (B lynch suture Group) (p-value=0.0001). Conclusion: In cases of placenta previa, prophylactic balloon tamponade resulted in reduced post-intervention mean blood loss compared to B-lynch. (author)