A Randomized Controlled Trial of Prophylactic Bakri Balloon Tamponade versus Standard Oxytocin Infusion for Placenta Previa Hemorrhage prevention

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1023–1034

DOI: 10.46882/2026/IJOG/000566

Original Research Article

Title: A Randomized Controlled Trial of Prophylactic Bakri Balloon Tamponade versus Standard Oxytocin Infusion for Placenta Previa Hemorrhage prevention

Names of Authors: William Brooks¹, Lars Eriksson²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, University of Oxford, Oxford, United Kingdom
² Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway

Abstract:
Placenta previa is associated with severe intraoperative and postpartum hemorrhage originating from a poorly contractile lower uterine segment during cesarean section. This randomized controlled trial evaluated the efficacy of prophylactic Bakri balloon tamponade placement immediately following placental extraction during cesarean delivery for complete placenta previa. One hundred and twenty pregnant women undergoing scheduled cesarean sections for complete placenta previa were randomized to either the prophylactic Bakri balloon group (n = 60) or the conventional management control group (oxytocin infusion plus standard surgical hemostatic sutures; n = 60). The primary outcome measured was total calculated perioperative blood loss. The mean total intraoperative and postoperative blood loss was significantly lower in the Bakri balloon group compared to the control group (642.5 ± 180.4 mL vs. 982.6 ± 285.4 mL, p < 0.001). The requirement for emergency secondary surgical interventions, such as uterine artery ligation or B-Lynch sutures, was significantly reduced in the balloon cohort (1.7% vs. 11.7%, p = 0.028). Blood transfusion requirements were also significantly decreased in the prophylactic intervention arm (5.0% vs. 18.3%, p = 0.024). There were no cases of balloon displacement, uterine rupture, or secondary pelvic infections in the intervention group. Prophylactic application of the Bakri balloon tamponade during cesarean sections for complete placenta previa is a safe strategy that effectively reduces perioperative blood loss and limits additional surgical interventions.

Keywords: Placenta Previa; Bakri Balloon; Postpartum Hemorrhage; Cesarean Section; Balloon Tamponade; Blood Transfusion.

Manuscript Timeline: Received: July 05, 2026; Revised: September 02, 2026; Accepted: September 16, 2026; Published: September 26, 2026.

Citation: Brooks W, Eriksson L. A Randomized Controlled Trial of Prophylactic Bakri Balloon Tamponade versus Standard Oxytocin Infusion for Placenta Previa Hemorrhage prevention. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1023–1034.

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