[Obstetric hemorrhage control Bakri balloon]. / Control de la hemorragia obstétrica con balón de Bakri.

BACKGROUND: Obstetric hemorrhage is the second leading cause of maternal death in Mexico. Intrauterine tamponades are a valuable resource for the limitation of bleeding. OBJECTIVE: Analyze the success rate of the Bakri balloon in the control of obstetric hemorrhage and calculate the fill volume with clinical parameters. MATERIAL AND METHODS: Descriptive, retrospective and observational study Subjects were included who presented refractory hemorrhage on administration of uterotonics (postpartum, caesarean section, post-caesarean section, and post-miscarriage); a Bakri balloon was inserted with epidural anesthesia. The procedure was considered successful where there was immediate cessation of hemorrhage without recurrence. The fill volume in milliliters (FV) was analyzed with a linear regression that included gestational age in weeks (GA) and neonatal weight in grams (NW). RESULTS: The study included 35 subjects: 20 postpartum (57.1%), 10 caesarean and post-caesarean section (28.5%), and 5 post-miscarriage (14.2%). Use of the Bakri balloon was successful in 33 cases (94.2%). Unsuccessful cases involved subinvolution of the placental site and placenta accreta. Fill volume correlated with gestational age (r=0.50, p=0.001) and with neonatal weight (r=0.47, p=0.002). The linear regression equation for calculation of the fill volume is FV = 150 + (4.3 x GA) + (0.03 x NW), (p = 0.003). CONCLUSION: Use of the Bakri balloon is safe, simple, and effective; we encountered no adverse reactions in this study. The procedure can be carried out after delivery or miscarriage or during or after a caesarean section.

[Urethral erosion secondary to the placing of tension-free vaginal tape. A case report]. / Erosión uretral secundaria a la colocación de una cinta vaginal libre de tensión. Reporte de un caso.

UNLABELLED: Tension free vaginal tape is a minimally invasive surgical procedure for urinary incontinence treatment. Urethral erosion is an uncommon complication which presents in around 0.9% of the cases after the procedure. CASE: Female of 68-year-old with an urodynamic diagnosis of type II stress urinary incontinence treated surgically with a tension free vaginal tape in February 2003 without any intraoperative complications. In the post-op she had acute urinary retention for one week, needing a transurethral catheter. Three months after surgery she reported dysuria, hematuria, frequency and urgency; the physical examination was normal with a positive urine culture to Escherichia coli sensitive to Nitrofurantoine. A cystoscopy was performed with the following findings: the tape was found in 25% of the right lower quadrant mid third of the urethra, the tape was cut vaginally without any further complications.