{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T07:08:35Z","timestamp":1779260915555,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016766","name":"New Venture Fund","doi-asserted-by":"publisher","award":["NVF\u2010NGDF\u2010UNIV1\u2010Subgrant\u2010011970\u20102021\u201001\u201001"],"award-info":[{"award-number":["NVF\u2010NGDF\u2010UNIV1\u2010Subgrant\u2010011970\u20102021\u201001\u201001"]}],"id":[{"id":"10.13039\/100016766","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare low\u2010cost \u201cSuction Tube Uterine Tamponade\u201d (STUT) treatment for refractory postpartum hemorrhage (PPH) with uterine balloon tamponade (UBT) using a randomized feasibility study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After verbal assent, we allocated participants with refractory PPH by randomly ordered envelopes to STUT or routine UBT at 10 hospitals in South Africa and one tertiary referral center in Colombia between January 10, 2020, and May 3, 2024. In the STUT group, we inserted a 24 FG Levin stomach tube into the uterine cavity and applied suction. The control group received standard UBT, mainly the Elavi free\u2010flow balloon or the Bakri fixed volume balloon. There were fundamental differences between the South African and the Colombian sites, so the pre\u2010specified analysis combined data from the two countries by meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 59 participants. The rate of the primary outcome (blood loss &gt;1000\u2009mL or laparotomy or death) was 8\/27 (30%) in the STUT group versus 14\/27 (52%) in the UBT group (risk ratio [RR] 0.56, 95% confidence interval [CI] 0.30\u20131.05, <jats:italic>P<\/jats:italic>\u2009=\u20090.07). Per protocol analysis was 7\/26 (27%) versus 15\/28 (54%) (RR 0.49, 95% CI 0.25\u20130.96, <jats:italic>P<\/jats:italic>\u2009=\u20090.04). Reporting severe pain during the procedures was less frequent in the STUT group (RR 0.46, 95% CI 0.25\u20130.86, <jats:italic>P<\/jats:italic>\u2009=\u20090.01). Most secondary outcomes favored the STUT group, with low certainty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>STUT was experienced as less painful than UBT. Results were consistent with reported observational findings and one other randomized trial evidence of greater effectiveness for suction than balloon tamponade.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.16164","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T13:54:48Z","timestamp":1737726888000},"page":"326-337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Suction tube uterine tamponade versus uterine balloon tamponade for treatment of refractory postpartum hemorrhage: A randomized clinical feasibility trial"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4193-8786","authenticated-orcid":false,"given":"Mandisa","family":"Singata\u2010Madliki","sequence":"first","affiliation":[{"name":"Effective Care Research Unit University of the Witwatersrand and Walter Sisulu University  East London South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5639-9127","authenticated-orcid":false,"given":"Albaro J.","family":"Nieto\u2010Calvache","sequence":"additional","affiliation":[{"name":"Unidad De Alta Complejidad Obstetrica, Fundaci\u00f3n Valle Del Lili  Cali Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7980-8595","authenticated-orcid":false,"given":"Luisa F.","family":"Rivera Torres","sequence":"additional","affiliation":[{"name":"Centro De Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle Del Lili  Cali Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hazmath","family":"Abdul","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology, Queen Nandi Regional Hospital, Empangeni University Of Kwazulu\u2010Natal  KwaZulu\u2010Natal South\u00a0Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Batting","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit University of the Witwatersrand and Walter Sisulu University  East London South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6312-165X","authenticated-orcid":false,"given":"Sylvia N.","family":"Cebekhulu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Bongani Regional Hospital University of the Free State, Department of Health  Bloemfontein South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7051-6959","authenticated-orcid":false,"given":"Lawrence","family":"Chauke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences University of the Witwatersrand, and Charlotte Maxeke Johannesburg Academic Hospital  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priya","family":"Soma\u2010Pillay","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Steve Biko Academic Hospital University of Pretoria, UP\/SAMRC Research Centre for Maternal, Fetal, Newborn and Child Healthcare Strategies  Pretoria South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Fawcus","sequence":"additional","affiliation":[{"name":"Department Obstetrics and Gynaecology University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-7116","authenticated-orcid":false,"given":"Logie","family":"Govender","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology, Queen Nandi Regional Hospital, Empangeni University Of Kwazulu\u2010Natal  KwaZulu\u2010Natal South\u00a0Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Busiwe","family":"Majeke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology at Cecilia Makiwane Hospital And Walter Sisulu University  East London South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6113-3091","authenticated-orcid":false,"given":"Xolani","family":"Mbongozi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Nelson Mandela Academic Hospital, Walter Sisulu University  Mthatha South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Middleton","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Frere Hospital and Walter Sisulu University  East London South\u00a0Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1879-7137","authenticated-orcid":false,"given":"Poovangela","family":"Naidoo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Chris Hani Baragwaneth Academic Hospital, University of the Witwatersrand  Johannesburg South\u00a0Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9432-2198","authenticated-orcid":false,"given":"Sanele","family":"Ndaba","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Kalafong Hospital University of Pretoria  Pretoria South\u00a0Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevi","family":"Spence","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology New Somerset Hospital  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaynor M.","family":"Balie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences University of the Witwatersrand, and Charlotte Maxeke Johannesburg Academic Hospital  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7669-1807","authenticated-orcid":false,"given":"Angelica","family":"Monroy","sequence":"additional","affiliation":[{"name":"Unidad De Alta Complejidad Obstetrica, Fundaci\u00f3n Valle Del Lili  Cali Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Cantor","sequence":"additional","affiliation":[{"name":"Unidad De Alta Complejidad Obstetrica, Fundaci\u00f3n Valle Del Lili  Cali Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3080-1007","authenticated-orcid":false,"given":"G. 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