The Condom Water Balloon Compression Method in Vaginal Delivery and Postpartum Hemorrhage: All patients had postoperative indwelling catheters, antibiotics, and uterotonics, with parallel perineal wipe washes to maintain genital cleanliness. When removing the intravenous infusion of oxytocin, rigorous disinfection of the vulva and vagina was performed. The catheter was cut for bureaucratic vaginal ligature, saline was slowly released, and a condom was clamped. The fornix was placed with lysis winding part, taking a water balloon, cutting the catheter knot line to release saline, and then another was taken; the specific volume of normal saline is shown in Table 1.
Table 1 shows the condom water balloon placement time and water volume. Results: After removal of the condom in all patients, uterine contractions were observed without active vaginal bleeding or vaginal wall hematoma, and vital signs remained stable. After 2 days, five cases had body temperatures between 37.5°C ~ 38.5°C, continuing anti-infective therapy brought them back to normal, with odorless lochia and Grade perineal wound healing. Follow-up at 42 days showed no late postpartum hemorrhage or puerperal infection, with good involution of the perineum and uterus.
Discussion: Postpartum hemorrhage is one of the main reasons for maternal deaths and can often endanger the lives of patients if not treated in time. Traditional treatments for vaginal delivery include uterine massage for uterine inertia, uterotonics to promote uterine contraction, and bureaucratic gauze. In placenta previa, where the placenta attaches to the lower uterine segment, the lower uterine segment after stripping has poor shrinkage, and diffuse oozing on the stripping surface cannot be ligated. Only officials' reduction agent massage and bureaucratic gauze are applied. Gauze used to stop bleeding sometimes ignores gaps left on both sides of the official or the packing is not tight, leading to occult bleeding. Tight filling impacts the rhythmic contractions of the uterine body itself. Filling the uterine cavity, especially the lower uterine segment, with too much gauze stuffed too tightly, poses the danger of bursting the lower uterine segment and cervix.
Condoms made of natural latex are non-toxic and widely used in contraception. Built-in normal saline by pressure sterilization ensures condoms are safe, sterile, tough, and plastic. Through the water in the intrauterine capsule pressure, the shape of the water bladder changes according to the uterine cavity, compressing the sinuses of the placental separation surface, closing the bladders of uterine angiotensin for closed hemostasis. Oppression covers a wide area with no dead space for hemorrhage and does not impact uterine contraction.
Excluding uterine rupture, due to uterine atony and placental separation surface oozing bleeding problems, bureaucratic bladder oppression methods provide rapid and effective hemostasis. For cervical severe erosion, diffuse oozing wounds without bleeding limitations, suture inconvenience may lead to future cervical contracture from excessive sutures, and no sutures are unable to stop the bleeding. The condom water balloon compression method solves this problem. None of the patients required stitching as the toughness of the bladder closely surrounded the cervix, not affecting the intrauterine blood flow. It could squeeze the cervical erosion surface, completely stopping the bleeding after being placed for 6h, achieving better results.
Continued bleeding after deep vaginal wall tears, submucosal vessel ruptures or vaginal inflammation, mucosal congestion, and edema often leads to pinhole bleeding after suturing or vaginal wall hematoma clearance. The traditional method using gauze packing oppression for prevention encounters difficulties in practice, often feeling that too much filling or gauze is too small to play a hemostasis effect. The local application of the condom water balloon compression method allows arbitrary increase or decrease in the pressure required to inject saline, making it easy to use with good results.
In summary, for patients undergoing vaginal delivery, if there is uterine inertia, placenta previa, cervical erosion, tearing, or vaginal wall hematoma due to postpartum hemorrhage, the condom water balloon compression method is a rapid and effective hemostasis method. It is simple, easy to use, and does not increase patient suffering. This recommended method does not require high technology and can be implemented in general township hospitals, especially those farther away from the county where township hospitals are inaccessible.