Efficacy of Prophylactic Antibiotics in Bakri Intrauterine Balloon Placement: A Single-Center Retrospective Analysis and Literature Review

Abstract

Objective Bakri intrauterine balloon (BIUB) placement is an effective treatment for postpartum hemorrhage (PPH). This study aims to evaluate the risk of infection during BIUB placement.

Study Design Data for all deliveries (n = 2,144) at our institution between January 2014 and March 2018 were retrospectively reviewed. Patients diagnosed with PPH (n = 758) were included in our analysis, further divided into BIUB (n = 80) and non-BIUB groups (n = 678), and subdivided into vaginal delivery (VD), elective cesarean delivery (CD), and emergency CD groups. Postpartum endometritis rate was compared in each group. A single dose of prophylactic antibiotics was administered for BIUB placement in the VD group. In the CD groups, antibiotics were administered preoperatively once, and no additional antibiotics for BIUB placement were administered. To obtain an antibiotics administration protocol to be applied during BIUB placement, we electronically searched the PubMed and Scopus databases.

Results No significant differences were observed in endometritis rates between BIUB and non-BIUB groups of all groups. In the literature review, of 27 suitable publications identified, multiple doses of antibiotics were administered in 17 (62.9%) studies and none investigated the efficacy of a protocol for antibiotic.

Conclusion Our protocol might be effective and sufficient in preventing postpartum BIUB placement-related endometritis.

Keywords

Bakri balloon - balloon tamponade - complication - endometritis - prophylactic antibiotics - postpartum hemorrhage

Authors' Contribution

Y.N., S.M., Y.K., M.E., A.K., and T.T. contributed to study conception and design, data collection, and drafting of the manuscript. M.E., T.T., and T.K. investigated the articles identified in the literature search. A.K. performed an extensive revision of the revised manuscript. T.K. conceived the study, provided general supervision, helped draft the manuscript, and gave final approval for publication of the manuscript. All authors read and approved the final version of the manuscript.

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