Obstetric Haemorrhage

Balloon tamponade: first line 'surgical' measure

• Bakri balloon inflated in uterus with warm saline

Laparotomy

• B Lynch suture: a brace suture that acts similarly to bimanual compression
• Tying off uterine, ovarian or iliac arteries to try and reduce uterine bleeding. All are potentially difficult to do and evidence suggests balloon tamponade may be more effective

Interventional radiology

• Intra-arterial balloon may be placed electively in known high risk cases e.g. praevia with accreta and inflated when needed
• More difficult in emergency settings

Hysterectomy - sometimes subtotal (leaving cervix) as more difficult with a gravid uterus

• This is a last resort if all other measures have been exhausted