Types of balloons not designed for intrauterine use that may be effective if an intrauterine balloon is not available (all are single-use and off-label)

Type	Composition	Manufacturer-recommended maximum fill volume	Actual filling capacity (as demonstrated by in vitro studies)*^[9]	Maximum time	Features/original design	Limitations
Rusch urologic hydrostatic balloon^[1]	Natural latex	500 to 1500 mL	Not reported	24 hours	Potential for large volume of inflation	Off-label use
Sengstaken-Blakemore Tube^[2,3]	Natural latex	250 mL (gastric balloon)	3350 mL	24 hours	Two-balloon catheter designed originally to stop bleeding from esophageal varices	Off-label use Long tip on catheter must be trimmed to aid proper placement
Condom catheter^[2,4-6]	Latex, plastic, lambskin	200 to 500 mL^[7]	4750 mL	24 hours	Condom affixed to a straight urinary catheter Kit designed for and tested in resource-poor settings May assemble out of available local resources Very low cost	Requires assembly Need to clamp catheter to avoid efflux of fluid filling balloon Single lumen catheter, which may not allow egress of blood from uterus
Glove catheter^[8]	Nonlatex surgical glove affixed by a tie to a catheter	Fill until the balloon starts to bulge at the cervix	Not reported	24 hours	Option for resource-poor settings Very low cost	Requires assembly Need to clamp catheter to avoid efflux of fluid filling balloon Single lumen catheter, which may not allow egress of blood from uterus

* Actual filling capacity (prior to balloon rupture) may be higher than the maximum manufacturer-recommended fill volumes and is important to note if instillation of additional fluid is required to effectively stop bleeding.

References:

Lau MS, Tee JC. Use of a large Rusch hydrostatic catheter balloon to control postpartum haemorrhage resulting from a low placental implantation. Singapore Med J 2009; 50:e321.
Seror J, Allouche C, Elhaik S. Use of Sengstaken-Blakemore tube in massive postpartum hemorrhage: a series of 17 cases. Acta Obstet Gynecol Scand 2005; 84:660.
Ishii T, Sawada K, Koyama S, et al. Balloon tamponade during cesarean section is useful for severe post-partum hemorrhage due to placenta previa. J Obstet Gynaecol Res 2012; 38:102.
Mvundura M, Kokonya D, Abu-Haydar E, et al. Cost-effectiveness of condom uterine balloon tamponade to control severe postpartum hemorrhage in Kenya. Int J Gynaecol Obstet 2017; 137:185.
Kandeel M, Sanad Z, Ellakwa H, et al. Management of Postpartum Hemorrhage With Intrauterine Balloon Tamponade Using a Condom Catheter in an Egyptian Setting. Int J Gynaecol Obstet 2016; 135:272.
Thapa K, Malla B, Pandey S, Amatya S. Intrauterine Condom Tamponade in Management of Post Partum Haemorrhage. J Nepal Health Res Counc 2010; 8:19.
Mollazadeh-Moghaddam K, Dundek M, Bellare A, et al. Mechanical Properties of the Every Second Matters for Mothers-Uterine Balloon Tamponade (ESM-UBT) Device: In Vitro Tests. AJP Rep 2019; 9:e376.
Baskett TF. Surgical management of severe obstetric hemorrhage: experience with an obstetric hemorrhage equipment tray. J Obstet Gynaecol Can 2004; 26:805.
Antony KM, Racusin DA, Belfort MA, Dildy GA 3rd. Under Pressure: Intraluminal Filling Pressures of Postpartum Hemorrhage Tamponade Balloons. AJP Rep 2017; 7:e86.

Courtesy of Karin A. Fox, MD, MEd.

Graphic 128496 Version 2.0

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Types of balloons not designed for intrauterine use that may be effective if an intrauterine balloon is not available (all are single-use and off-label)