To analyze the clinical characteristics of uterine rupture caused by intrauterine balloon tamponade in postpartum hemorrhage.

The diagnosis and treatment of a case of uterine rupture caused by intrauterine balloon tamponade was reviewed. MEDLINE, Wanfang database, VIP, CNKI, Chinese Biomedical Database and Embase database from 2000 to 2020 were searched using keywords "postpartum hemorrhage" , "intrauterine balloon" , "uterine tamponade" , "uterine rupture" , "Bakri balloon" , "uterine atony" and "hysterectomy" . Diagnosis and treatment of uterine rupture complicating uterine balloon tamponade were abstracted and analyzed.

In the literature, together with this case, 9 cases of intrauterine balloon tamponade complicated with uterine rupture were identified. 7 cases used Bakri balloon, 1 case used BT-Cath balloon and 1 case used intrauterine balloon. Indications for balloon placement included uterine atony after vaginal delivery in 3 cases, placenta previa after cesarean section in 2 cases, and late postpartum hemorrhage in 4 cases. Uterine rupture occurred during intrauterine balloon placement in 2 cases and during uterine tamponade in 7 cases. Among 5 cases of primary postpartum hemorrhage with uterine rupture, 4 cases underwent uterine repair and 1 case had hysterectomy; while in women with late postpartum hemorrhage and uterine rupture, hysterectomy was performed in all the 4 cases.

Doctors should be aware that uterine rupture is a severe complication of intrauterine balloon tamponade. Uterine balloon should be placed under ultrasound monitoring. If a patient had hemodynamic instability after uterine tamponade, uterine rupture should be suspected.