Role of Foley’s Catheter as Intra-Uterine Balloon Tamponade in Controlling Primary Post-Partum Hemorrhage after Vaginal Delivery

One of the leading causes of maternal morbidity and mortality is primary post-partum hemorrhage (PPH). The utilization of intrauterine balloon tamponade has drastically reduced this deadly complication. In low-resource areas, the balloon of a 24-French Foley catheter is used for the same purpose. Objectives: To determine the safety and success rate of 24 Fr Foley’s catheter as intra-uterine balloon tamponade in controlling Primary Post-Partum Hemorrhage after vaginal delivery. To determine the amount of bleeding at 15 and 30 minutes after the Foleys insertion to predict failure. Methods: This cross-sectional study included 140 consecutive women with PPH after failed medical treatment. A 24-French Foley catheter was placed in the uterine cavity, and the balloon was filled with 100 ml of normal saline. Bleeding was observed for the next 15 and 30 minutes. Results: The Foley Balloon tamponade was successful in controlling hemorrhage in 125 (89.2%) patients. While 15 (9.8%) patients had failed balloon tamponade. Patients with failed balloon tamponade had a higher rate of anemia, coagulopathy, and more bleeding after delivery, after 15 minutes, and after 30 minutes of Foley balloon placement. The positive predictive value for 150 ml and 200 ml was 0.60 and 0.80, respectively. Conclusions: It was concluded that the 24 Fr Foley is effective in controlling primary post-partum hemorrhage. A blood loss of ≥200 ml after 15 minutes of Foley balloon placement should alert the physician to adopt a more aggressive approach to control bleeding.