Postpartum HemorrhageBakriNCT01980173
Medico-economic Comparison of Postpartum Hemorrhage Management Using the Bakri Balloon and Standard Care
A study testing Routine care and Bakri balloon in people with Postpartum Hemorrhage, run by Centre Hospitalier Universitaire de Nīmes at 7 sites in France.
Trial summary
This study concerns women diagnosed with postpartum hemorrhage and requiring sulprostone therapy. Included patients are randomized to two arms: the "Sulprostone + Bakri balloon" arm versus the "Sulprostone alone" arm. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Postpartum Hemorrhage
- What is being tested?
- Routine care and Bakri balloon
- Type of treatment
- Injection or infusion, Medical device, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 26 participants
- Where
- 7 sitesFrance
- Study dates
- 5 Sep 2014to 30 Mar 2017
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- The patient, her person-of-trust, must have given his/her consent and signed the consent form / inclusion decision made by the investigator when a person-of-trust is absent
- The patient must be insured or beneficiary of a health insurance plan
- The patient is able to fluently read and speak French
- Blood loss > 500ml and sulprostone treatment is insufficient at 20 minutes
- Duration of pregnancy > 32 weeks of amenorrhea
- Uterine atony
Who cannot join
- The patient is participating in another study except for the followin studies: ElastoMAP, ElastoDéclench, Papillo PMA, GrossPath, LXRs, DGPostPartum
- The patient is in an exclusion period determined by a previous study
- The patient is under judicial protection, under tutorship or curatorship
- The patient refuses to sign the consent
- It is impossible to correctly inform the patient
- The patient cannot read French
Show all 10Show fewer
- The patient was transferred to another center not among the centers participating in this study
- The patient has a contraindication for a treatment used in this study (Sulprostone), or an incompatible treatment combination
- The patient has a contraindication for third level techniques
- The patient has at least one of the following conditions: chorioamnionitis, cervical cancer, uterine rupture, anatomical abnormality preventing the introduction of the device, purulent infection of the vagina, cervix or uterus.
Trial locations and contacts
7 sites in 1 country.
7 sites in 1 country
France7 sites
CHU d'Angers - Hôtel-Dieu
Angers, 49933
APHP - Hôpital Antoine Beclere
Clamart, 92141
APHP - Centre Hospitalier Universitaire de Bicêtre
Le Kremlin-Bicêtre, 94275
APHM - Hôpital Nord
Marseille, 13915
CHRU de Montpellier - Hôpital Arnaud de Villeneuve
Montpellier, 34295
CHRU de Nîmes - Hôpital Universitaire Carémeau
Nîmes, 30029
CHU de Saint Etienne - Hôpital Nord
Saint-Priest-en-Jarez, 42270
About this study
This study concerns women diagnosed with postpartum hemorrhage and requiring sulprostone therapy. Included patients are randomized to two arms: the "Sulprostone + Bakri balloon" arm versus the "Sulprostone alone" arm.
The main objective of this study is to compare the efficiency of a care strategy including the Bakri balloon to that of routine care without the Bakri balloon via a cost-consequence study juxtaposing costs and the necessity of invasive procedures (arterial embolization, ligation of arteries, hysterectomy, intrauterine sutures) for controlling postpartum hemorrhage.
- Conditions
- Postpartum Hemorrhage
- Being tested
- Routine care, Bakri balloon
- Keywords
- Bakri balloon
- Medical subject headings
- Postpartum Hemorrhage
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Routine careProcedure or surgery
Following diagnosis with post-partum hemorrhage, an initial 30 minute phase corresponding to current recommendations, an injection of sulprostone, a demonstrated inefficacy of sulprostone 20 minutes after the injection and finally randomization, patients in this arm of the study will continue to have routine care.
Bakri balloonDevice
Following diagnosis with post-partum hemorrhage, an initial 30 minute phase corresponding to current recommendations, an injection of sulprostone, a demonstrated inefficacy of sulprostone 20 minutes after the injection and finally randomization, patients in this arm will be treated with the immediate placement of a Bakri balloon, followed by routine care if necessary.
| Study group | Role | What they receive |
|---|---|---|
| With Bakri balloon | Experimental | Patients randomized to this arm will be treated using the Bakri balloon.
Intervention: Bakri balloon Receives: Device: Bakri balloon |
| Without Bakri balloon | Active comparator | Patients randomized to this arm will receive routine care not including the Bakri Balloon.
Intervention: Routine Care Receives: Procedure: Routine care |
What is being measured
The primary outcome is the main question the study is designed to answer.
The % of patients requiring invasive measures for postpartum hemorrhage control.
Measured: Hospital stay (expected max of 15 days).
The total cost (€) associated with the postpartum hemorrhage management strategy.
Measured: Hospital stay (expected max of 15 days).
Secondary outcomes (63)
The delay required to stop bleeding post-delivery (min)
Measured: post-partum (expected maximum of a few hours)
The delay required to stop bleeding post-diagnosis (min)
Measured: post-partum (expected maximum of a few hours)
The percentage of patients still bleeding 30 minutes after sulprostone injection
Measured: 30 minutes after sulprostone injection (day 0)
Blood loss (ml) 30 minutes after diagnosis
Measured: 30 minutes after diagnosis (day 0)
Blood loss (ml) 1 hour after diagnosis
Measured: 1 hour after diagnosis (day 0)
Blood loss (ml) 2 hours after diagnosis
Measured: 2 hours after diagnosis (day 0)
Blood loss (ml) 24 hours after diagnosis
Measured: 24 hours after diagnosis (day 1)
Blood pressure
Measured: Upon diagnosis (day 0)
Blood pressure
Measured: 30 minutes after diagnosis (day 0)
Blood pressure
Measured: 120 minutes after diagnosis (day 0)
Blood pressure
Measured: 24 hours after diagnosis (day 1)
Blood pressure
Measured: upon sulprostone injection (day 0)
Blood pressure
Measured: when placing the Bakri balloon (day 0)
Blood pressure
Measured: when performing invasive techniques (expected day 0 or 1)
Heart rate
Measured: Upon diagnosis (day 0)
Heart rate
Measured: 30 minutes after diagnosis (day 0)
Heart rate
Measured: 120 minutes after diagnosis (day 0)
Heart rate
Measured: 24 hours after diagnosis (day 1)
Heart rate
Measured: upon sulprostone injection (day 0)
Heart rate
Measured: when placing the Bakri balloon (day 0)
Heart rate
Measured: when performing invasive techniques (expected day 0 or 1)
The % of patients requiring blood transfusion.
Measured: Hospital stay (expected max of 15 days).
The % of patients requiring intravenous iron.
Measured: Hospital stay (expected max of 15 days).
The quantity of packed red cells, platelet concentrate and fresh frozen plasma consumed
Measured: Hospital stay (expected max of 15 days).
Fibrinogen (g / l)
Measured: Upon diagnosis (day 0)
Fibrinogen (g / l)
Measured: Day 1
Fibrinogen (g / l)
Measured: Day 3
Hematocrit (%)
Measured: Upon diagnosis (day 0)
Hematocrit (%)
Measured: Day 1
Hematocrit (%)
Measured: Day 3
Hematocrit (%)
Measured: the month preceding delivery
Hemoglobin (g/dl)
Measured: Upon diagnosis (day 0)
Hemoglobin (g/dl)
Measured: Day 1
Hemoglobin (g/dl)
Measured: Day 3
Hemoglobin (g/dl)
Measured: the month preceding delivery
Prothrombin (%)
Measured: the month preceding delivery
Prothrombin (%)
Measured: Upon diagnosis (day 0)
Prothrombin (%)
Measured: Day 1
Prothrombin (%)
Measured: Day 3
Activated partial thromboplastin time (s)
Measured: the month preceding delivery
Activated partial thromboplastin time (s)
Measured: Upon diagnosis (day 0)
Activated partial thromboplastin time (s)
Measured: Day 1
Activated partial thromboplastin time (s)
Measured: Day 2
Length of hospital stay (days)
Measured: Expected max of 15 days
Length of ICU stay
Measured: expected max of 15 days
Antimullerian hormone level
Measured: Upon diagnosis (Day 0)
Antimullerian hormone level
Measured: 2 months after restart of menses
Amenorrhea at 3 months? yes/no
(Excluding breastfeeding women)
Measured: 3 months
The presence of adhesions detected at hysteroscopy
Measured: 3 months after delivery if menses have restarted, or 2 months after the restart of menses (maximum of 1 year after inclusion)
pain will be assessed in both arms via a visual analog scale, duration, location, and use of analgesics
Measured: Day 1
pain will be assessed in both arms via a visual analog scale, duration, location, and use of analgesics
Measured: Day 3
temperature (°C)
Measured: Daily while in hospital (expected maximum of 15 days)
FSFI questionnaire (Female Sexual Function Index)
Measured: 6 months
Doppler ultrasound: intrauterine pressure
Measured: when placing the Bakri balloon; day 0
Doppler ultrasound: thickness of the uterine wall
Measured: when placing the Bakri balloon; day 0
Doppler ultrasound: inversed diastolic flow
Measured: when placing the Bakri balloon; day 0
Doppler ultrasound: intraluminal pressure
Measured: when placing the Bakri balloon; day 0
Doppler ultrasound: uterine artery perfusion pressure
Measured: when placing the Bakri balloon; day 0
Doppler ultrasound: uterine artery pulsatility index
Measured: when placing the Bakri balloon; day 0
IES-R scale (symptoms of post-traumatic stress)
Measured: 6 months
Vascular filling required? yes/no
Measured: Day 0
If vascular filling is required, volume and type of solution used.
Measured: Day 0
Were amines required? yes/no
Measured: Day 0
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Nov 2013 (estimated)
- Study start5 Sep 2014
- Primary completion26 Sep 2016
- Study completion30 Mar 2017
Why it stopped: recruitment difficulties
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Postpartum HemorrhageStudies of the same condition, open and under way.
- More trials run by Centre Hospitalier Universitaire de NīmesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 26 participants (actual)
Sponsor and investigators
- Lead sponsor
- Centre Hospitalier Universitaire de Nīmes
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Vincent Letouzey, MD, Principal investigator, Centre Hospitalier Universitaire de Nīmes
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01980173
- Sponsor's protocol ID
- LOCAL/2012/VL-04
- Other IDs
- 2013-A00914-41
- Acronym
- Bakri
- Status last verified
- Sep 2016
- First submitted
- 29 Oct 2013
- Last updated
- 11 May 2018
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Kellie FJ, Wandabwa JN, Mousa HA, Weeks AD. Mechanical and surgical interventions for treating primary postpartum haemorrhage. Cochrane Database Syst Rev. 2020 Jul 1;7(7):CD013663. doi: 10.1002/14651858.CD013663.
PubMed 32609374
Study at a glance
From the registry record, last updated by the sponsor on 11 May 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Medico-economic Comparison of Postpartum Hemorrhage Management Using the Bakri Balloon and Standard Care
- ClinicalTrials.gov ID
- NCT01980173
- Acronym / sponsor ID
- Bakri / LOCAL/2012/VL-04
- Conditions
- Postpartum Hemorrhage
- Keywords
- Bakri balloon
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: recruitment difficulties
- Enrolment
- 26 participants (actual)
- Lead sponsor
- Centre Hospitalier Universitaire de NīmesUniversity, hospital or other
- Study start
- 5 Sep 2014 (actual)
- Primary completion
- 26 Sep 2016 (actual)
- Study completion
- 30 Mar 2017 (actual)
- First posted
- 8 Nov 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study concerns women diagnosed with postpartum hemorrhage and requiring sulprostone therapy. Included patients are randomized to two arms: the "Sulprostone + Bakri balloon" arm versus the "Sulprostone alone" arm.
The main objective of this study is to compare the efficiency of a care strategy including the Bakri balloon to that of routine care without the Bakri balloon via a cost-consequence study juxtaposing costs and the necessity of invasive procedures (arterial embolization, ligation of arteries, hysterectomy, intrauterine sutures) for controlling postpartum hemorrhage.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| With Bakri balloon | Experimental | Device: Bakri balloonPatients randomized to this arm will be treated using the Bakri balloon. Intervention: Bakri balloon |
| Without Bakri balloon | Active comparator | Procedure: Routine carePatients randomized to this arm will receive routine care not including the Bakri Balloon. Intervention: Routine Care |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- The patient, her person-of-trust, must have given his/her consent and signed the consent form / inclusion decision made by the investigator when a person-of-trust is absent
- The patient must be insured or beneficiary of a health insurance plan
- The patient is able to fluently read and speak French
- Blood loss > 500ml and sulprostone treatment is insufficient at 20 minutes
- Duration of pregnancy > 32 weeks of amenorrhea
Key exclusion criteria (10 listed)
- The patient is participating in another study except for the followin studies: ElastoMAP, ElastoDéclench, Papillo PMA, GrossPath, LXRs, DGPostPartum
- The patient is in an exclusion period determined by a previous study
- The patient is under judicial protection, under tutorship or curatorship
- The patient refuses to sign the consent
- It is impossible to correctly inform the patient
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Routine careFollowing diagnosis with post-partum hemorrhage, an initial 30 minute phase corresponding to current recommendations, an injection of sulprostone, a demonstrated inefficacy of sulprostone 20 minutes after the injection and finally randomization, patients in this arm of the study will continue to have routine care. | Procedure or surgery | Without Bakri balloon |
| Bakri balloonFollowing diagnosis with post-partum hemorrhage, an initial 30 minute phase corresponding to current recommendations, an injection of sulprostone, a demonstrated inefficacy of sulprostone 20 minutes after the injection and finally randomization, patients in this arm will be treated with the immediate placement of a Bakri balloon, followed by routine care if necessary. | Device | With Bakri balloon |
Primary outcome
The % of patients requiring invasive measures for postpartum hemorrhage control.
Time frame: Hospital stay (expected max of 15 days).
The total cost (€) associated with the postpartum hemorrhage management strategy.
Time frame: Hospital stay (expected max of 15 days).
63 secondary outcomes
The delay required to stop bleeding post-delivery (min)
Time frame: post-partum (expected maximum of a few hours)
The delay required to stop bleeding post-diagnosis (min)
Time frame: post-partum (expected maximum of a few hours)
The percentage of patients still bleeding 30 minutes after sulprostone injection
Time frame: 30 minutes after sulprostone injection (day 0)
Blood loss (ml) 30 minutes after diagnosis
Time frame: 30 minutes after diagnosis (day 0)
Blood loss (ml) 1 hour after diagnosis
Time frame: 1 hour after diagnosis (day 0)
Blood loss (ml) 2 hours after diagnosis
Time frame: 2 hours after diagnosis (day 0)
Blood loss (ml) 24 hours after diagnosis
Time frame: 24 hours after diagnosis (day 1)
Blood pressure
Time frame: Upon diagnosis (day 0)
Blood pressure
Time frame: 30 minutes after diagnosis (day 0)
Blood pressure
Time frame: 120 minutes after diagnosis (day 0)
Blood pressure
Time frame: 24 hours after diagnosis (day 1)
Blood pressure
Time frame: upon sulprostone injection (day 0)
Blood pressure
Time frame: when placing the Bakri balloon (day 0)
Blood pressure
Time frame: when performing invasive techniques (expected day 0 or 1)
Heart rate
Time frame: Upon diagnosis (day 0)
Heart rate
Time frame: 30 minutes after diagnosis (day 0)
Heart rate
Time frame: 120 minutes after diagnosis (day 0)
Heart rate
Time frame: 24 hours after diagnosis (day 1)
Heart rate
Time frame: upon sulprostone injection (day 0)
Heart rate
Time frame: when placing the Bakri balloon (day 0)
Heart rate
Time frame: when performing invasive techniques (expected day 0 or 1)
The % of patients requiring blood transfusion.
Time frame: Hospital stay (expected max of 15 days).
The % of patients requiring intravenous iron.
Time frame: Hospital stay (expected max of 15 days).
The quantity of packed red cells, platelet concentrate and fresh frozen plasma consumed
Time frame: Hospital stay (expected max of 15 days).
Fibrinogen (g / l)
Time frame: Upon diagnosis (day 0)
Fibrinogen (g / l)
Time frame: Day 1
Fibrinogen (g / l)
Time frame: Day 3
Hematocrit (%)
Time frame: Upon diagnosis (day 0)
Hematocrit (%)
Time frame: Day 1
Hematocrit (%)
Time frame: Day 3
Hematocrit (%)
Time frame: the month preceding delivery
Hemoglobin (g/dl)
Time frame: Upon diagnosis (day 0)
Hemoglobin (g/dl)
Time frame: Day 1
Hemoglobin (g/dl)
Time frame: Day 3
Hemoglobin (g/dl)
Time frame: the month preceding delivery
Prothrombin (%)
Time frame: the month preceding delivery
Prothrombin (%)
Time frame: Upon diagnosis (day 0)
Prothrombin (%)
Time frame: Day 1
Prothrombin (%)
Time frame: Day 3
Activated partial thromboplastin time (s)
Time frame: the month preceding delivery
Results and safety
The study was stopped early (reason given: recruitment difficulties). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 May 2018.
- Derived from this study: PubMed 32609374Kellie FJ, Wandabwa JN, Mousa HA, Weeks AD. Mechanical and surgical interventions for treating primary postpartum haemorrhage. Cochrane Database Syst Rev. 2020 Jul 1;7(7):CD013663. doi: 10.1002/14651858.CD013663.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Vincent Letouzey, MD principal investigator
Centre Hospitalier Universitaire de Nīmes
7 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Routine care and Bakri balloon in people with Postpartum Hemorrhage, run by Centre Hospitalier Universitaire de Nīmes at 7 sites in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 11 May 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 7 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was stopped early (reason given: recruitment difficulties). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The % of patients requiring invasive measures for postpartum hemorrhage control. (time frame: Hospital stay (expected max of 15 days).). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01980173, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 May 2018.