USE OF REBOA FOR POSTPARTUM HEMORRHAGE: SCOPING REVIEW OF EFFICACY, SAFETY, AND GLOBAL APPLICATION FOR OBSTETRIC CARE erikgardnerh@gmail.com

PW07-09

USE OF REBOA FOR POSTPARTUM HEMORRHAGE: SCOPING REVIEW OF EFFICACY, SAFETY, AND GLOBAL APPLICATION FOR OBSTETRIC CARE

3

Mexico

Oral or Poster

The use of REBOA in trauma patients has been studied since the 1950’s; however, debate of its use in obstetrics remains controversial. Postpartum hemorrhage (PPH) remains the number one cause of death in obstetrics worldwide, an important global health metric. We sought to review the most current evidence regarding the use of REBOA in obstetrics and how its use can benefit patients globally, particularly in LMIC’s where 99% of PPH-related deaths occur.

Following PRISMA guidelines for scoping reviews, we screened an initial pool of 708 articles from PubMed, LILACS, EMBASE, and SCOPUS. 26 articles met inclusion criteria for review. The primary outcome of interest was patient mortality.

REBOA was found to effectively control PPH, contributing to a cleaner surgical field, decreased transfusion requirements, and decreased PPH-associated mortality. Prophylactic REBOA use was associated with adequate hemorrhage control and prevention. No significant differences in REBOA-associated mortality were observed. The use of REBOA, even with fluoroscopic aid, did not show an increased risk for adverse neonatal outcomes. Prophylactic endovascular management showed that it can help retain patient fertility, reduce transfusion, and vasopressor requirements, as well as shorten surgical times and reduce medical costs.

REBOA is safe and effective to control PPH and its use in LMICs can help reduce medical costs associated with massive transfusion of blood products and reduce mortality associated with exsanguinating hemorrhage. This presents an opportunity for the creation of guidelines that integrate trauma and acute care surgery principles, such as REBOA, to improve maternal and neonatal outcomes globally.