Uterine balloon tamponade (Bakri balloon) is used in the management of atonic PPH refractory to uterotonics. The 'tamponade test' is considered positive when:

• A The balloon volume exceeds 500 mL without bleeding control
• B Intrauterine pressure exceeds mean arterial pressure as measured by balloon manometry
• C Vaginal bleeding stops when digital pressure is applied to the uterine fundus
• D The balloon is inflated and bleeding from above the balloon ceases, suggesting uterine compression is effective ✓

Explanation

The tamponade test (Danso and Reginald, 2002) assesses whether an intrauterine balloon can control PPH: after balloon inflation (typically with warm saline 250–500 mL), if bleeding from the cervical os/drain tube stops or substantially diminishes, the test is positive, indicating that tamponade pressure is sufficient and further intervention (surgical or interventional radiology) may not be immediately required. A positive tamponade test means balloon tamponade alone may be definitive treatment. A negative test (continued bleeding despite inflated balloon) indicates need for escalation to B-Lynch suture, uterine artery ligation, or hysterectomy.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.