Management of Postpartum Hemorrhage With Intrauterine Vacuum-Induced Hemorrhage Control Device Versus Intrauterine Balloon Tamponade [ID 1170]

INTRODUCTION: Postpartum hemorrhage (PPH) is a prevalent and increasing source of morbidity, primarily due to uterine atony. After insufficient medical management, tamponade is attempted via uterine balloon (UBT) (brand: Bakri) or a novel intrauterine vacuum-induced control device (IVCD) (brand: Jada System). Although limited comparison data exists, few studies suggest increased effectiveness and decreased blood transfusions, infection rates, intensive care unit admission rates, and cost/resource utilization for IVCD. In this study, we sought to assess outcomes of PPHs managed using UBT or IVCD. METHODS: This is a single-site retrospective chart review. Patients who underwent PPH management using UBT or IVCD between February 2021 and December 2023 were included. Patient demographics, medical history, and intrapartum complications were collected. Data was presented as median with interquartile range and compared using Wilcoxon rank sum or t-tests. A value of P ≤.05 was considered statistically significant. RESULTS: A total of 293 PPHs were evaluated (IVCD n=253, UBT n=40). The mean age was 31.14 (±5.42, P =.4), 72% were White, and ∼70% had private insurance. Regardless of delivery route, IVCD demonstrated significantly lower overall quantitative blood loss (QBL) ( P <.0001), use of blood products ( P =.0008), and suction dilation and curettage ( P =.0004). No significant difference in uterotonic administration was detected. CONCLUSIONS/IMPLICATIONS: Our data is consistent with previous studies suggesting that PPH management with IVCD results in reduced QBL, blood product usage, and additional surgical procedures. This suggests lower overall health care costs. A cost analysis study is underway for further comparison. Future studies using IVCD prior to multiple uterotonic therapies to assess further improved outcomes and cost reduction are warranted.