(354) Implementation and Outcomes of an Intrauterine, Vacuum-Induced Hemorrhage-Control Device at a Community Hospital

Thursday, January 30, 2025

10:30 AM – 12:30 PM

Submitting Author and Presenting Author(s)

Shane P. Farrell, BS, DO

Resident Physician
St. Luke's University Health Network
Easton, Pennsylvania, United States

Coauthor(s)

SC

Sierra Camburn, BS

Medical Student
St. Luke’s University Health Network/Lewis Katz School of Medicine at Temple University
Bethlehem, Pennsylvania, United States
RO

Rachel O'Connell, MD

Attending Physician
St. Luke's University Health Network
Bethlehem, Pennsylvania, United States

Objective: Our study examined the real-world implementation and outcomes of an intrauterine vacuum-induced postpartum hemorrhage (PPH) control device (Jada) versus a balloon tamponade device (Bakri) in a community hospital setting. We aimed to determine the frequency of Jada use over Bakri and its impact on quantitative blood loss, need for blood transfusion, and further surgical intervention.

Study Design: This single-institution, retrospective, observational study analyzed PPH cases from January 2019 to July 2023. We identified cases using the electronic medical record with keywords “Jada” and “Bakri” to track mechanical device use. Primary outcomes included device failure, estimated or quantitative blood loss (EBL, QBL), need for blood transfusion, and further surgical intervention. Device failure was defined as a device that was placed but expelled or needed removal due to malfunction or inefficacy. Additional data included subject characteristics, number of uterotonics used, and type of surgical intervention.

Results: Over 4.5 years, 741 PPH cases were identified, with 88 managed using mechanical devices: 29 (32.9%) with Bakri and 57 (64.7%) with Jada. Within 18 months of the Jada device introduction, it was more frequently chosen over Bakri (p = 0.0001). Subject characteristics between the Jada and Bakri groups were not significantly different. Bakri device was more likely to fail than Jada when adjusting for gestational age, BMI, and ethnicity (RR 4.11, 95% CI 1.53-11.02). The Jada group experienced lower blood loss, fewer blood transfusions, and fewer surgical interventions and uterotonics (Table 2).

Conclusion: Our study showed that within 18 months of introducing the intrauterine vacuum device, it was preferred over balloon tamponade for PPH management, resulting in fewer device failures and better outcomes in terms of blood loss, uterotonic use, blood transfusions, and further surgical intervention.