Evaluation of Prophylactic Bakri Balloon Tamponade during Cesarean Delivery for Placenta Previa: A Randomized Controlled Trial

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 289–300

DOI: 10.46882/2026/IJOG/000501

Original Research Article

Title: Evaluation of Prophylactic Bakri Balloon Tamponade during Cesarean Delivery for Placenta Previa: A Randomized Controlled Trial

Names of Authors: Emeka J. Obi¹, Funmilayo R. Adeyemi², Zainab H. Dogara¹

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
² Maternal Health Division, Federal Ministry of Health, Abuja, Nigeria

Abstract:
Placenta previa is historically associated with severe intrapartum 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 stable, complete placenta previa were randomized to either the prophylactic Bakri balloon group (n = 60) or the conventional management group (oxytocin plus standard surgical hemostatic sutures; n = 60). The primary outcome measured was total perioperative blood loss. The mean total intraoperative and postoperative blood loss was significantly lower in the Bakri balloon group compared to the control group (645.2 ± 180.4 mL vs. 985.6 ± 290.2 mL, p < 0.001). The requirement for emergency secondary 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 requiring balloon removal in the intervention group. Prophylactic application of the Bakri balloon tamponade during cesarean sections for complete placenta previa is a safe, effective strategy that reduces perioperative blood loss and limits additional surgical interventions or blood transfusions.

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

Manuscript Timeline: Received: May 28, 2026; Revised: July 19, 2026; Accepted: August 06, 2026; Published: August 30, 2026.

Citation: Obi EJ, Adeyemi FR, Dogara ZH. Evaluation of Prophylactic Bakri Balloon Tamponade during Cesarean Delivery for Placenta Previa: A Randomized Controlled Trial. International Journal of Obstetrics and Gynecology. 2026; 14(8): 289–300.

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