%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Dumont, Alexandre
%A Bodin, C.
%A Hounkpatin, B.
%A Popowski, T.
%A Traoré, M.
%A Perrin, R.
%A Rozenberg, P.
%T Uterine balloon tamponade as an adjunct to misoprostol for the treatment of uncontrolled postpartum haemorrhage : a randomised controlled trial in Benin and Mali
%D 2017
%L fdi:010076290
%G ENG
%J BMJ Open
%@ 2044-6055
%K FEMME ; SANTE PUBLIQUE ; GROSSESSE ; NAISSANCE ; ESSAI CLINIQUE ; SERVICE DE MATERNITE ; POPULATION URBAINE
%K HEMORRAGIE POST PARTUM
%K BENIN ; COTONOU ; MALI ; BAMAKO
%M ISI:000412650700142
%N 9
%P e016590 [9 ]
%R 10.1136/bmjopen-2017-016590
%U https://www.documentation.ird.fr/hor/fdi:010076290
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-07/010076290.pdf
%V 7
%W Horizon (IRD)
%X Objective: To assess the effectiveness of low-cost uterine tamponade as an adjunct to misoprostol for the treatment of uncontrolled postpartum haemorrhage (PPH) in low-resource settings. Design Randomised controlled trial. Setting: Seven healthcare facilities in Cotonou, Benin and Bamako, Mali. Population: Women delivering vaginally who had clinically diagnosed PPH that was suspected to be due to uterine atony, who were unresponsive to oxytocin and who needed additional uterotonics. Methods: Women were randomly assigned to receive uterine balloon tamponade with a condom-catheter device or no tamponade; both groups were also given intrarectal or sublingual misoprostol. Main outcome measure Proportion of women with invasive surgery or who died before hospital discharge. Results: The proportion of primary composite outcome did not differ significantly between the tamponade arm (16%; 9/57) and the standard second line treatment arm (7%; 4/59): relative risk 2.33 (95% CI 0.76 to 7.14, p= 0.238). A significantly increased proportion of women with tamponade and misoprostol versus misoprostol alone had total blood loss more than 1000 mL: relative risk 1.52 (95% CI 1.15 to 2.00, p= 0.01). Case fatality rate was higher in the tamponade group (10%; 6/57) than in the control group (2%; 1/59) (p= 0.059).
%$ 050MEDECI