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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)

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:
  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. Baskett TF. Surgical management of severe obstetric hemorrhage: experience with an obstetric hemorrhage equipment tray. J Obstet Gynaecol Can 2004; 26:805.
  9. 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.
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