Introduction Postpartum haemorrhage (PPH) is one of the major causes of maternal mortality and morbidity worldwide. 1 It is estimated that 600,000-800,000 women die in childbirth each year and 99% of these occur in developing countries. 2 Overall, 25% of deaths in developing world are due to PPH, while the prevalence in Pakistan is 34%. 3 Primary PPH is defined as bleeding in excess of 500ml following vaginal delivery or 1000ml following caesarean section (CS) from the birth canal within 24 hours. 4 It has many potential causes, but the commonest is uterine atony, responsible for 80% of cases. Other causes of primary PPH include retained placental tissues, uterine rupture, lower genital tract trauma, uterine inversion and consumptive coagulopathy. 3 Guidelines for the management of PPH involve a stepwise approach, including the exclusion of retained products and genital tract trauma. Uterine atony is dealt with uterine rubbing and various uterotonic agents such as oxytocin, ergometrine, misoprostol and prostaglandin F2 alpha (PGF2α). If these attempts fail, surgical intervention would be required such as internal iliac artery ligation, uterine compression sutures and peripartum hysterectomy. Recently uterine balloon temponade has been added to this armamentarium in the management of PPH. 5 This procedure is used before any surgical intervention is done. Previously temponade was used to control PPH by uterine packing. Given the difficulty and potential traumatic procedure of insertion of roller gauze packs, the use of uterine balloon temponade has been favoured more recently. 6 Successful use of variety of balloon devices has been reported, including Sagstaken-Blakemore tube, Bakri balloon, Rusch balloon, Foley catheters and Condom catheters. 5 Success rates of 84% (95% confidence interval [CI], 77.5%-88.8%)[6] has been reported with the use of various balloons. Although reports of success and failure in the use of balloons for obstetric haemorrhage exist, but they do not necessarily include specific indications, methods used, balloon type or reasons for failure. 5 Success rates have been reported with use of condoms in low-resource settings. 7 As this is the least invasive and most rapid approach, it would be logical to use this as the first step in the management after medical treatment fails and before proceeding to surgical intervention and possible hysterectomy. 6 Advantages of this method include avoidance of laparotomy, easy and rapid insertion with minimal anaesthesia, the fact that it can be performed by J Pak Med Assoc 22 ORIGINAL ARTICLE Intrauterine balloon tamponade for the control of postpartum haemorrhage Rajni Lohano, 1 Gulfishan Haq, 2 Sarah Kazi, 3 Saima Sheikh 4 Abstract Objective: To evaluate the effectiveness of balloon temponade in the management of postpartum haemorrhage. Methods: The study was conducted at the Dow University of Health Sciences and Civil Hospital Karachi from January to July 18, 2012, and comprised women aged 18-35 years, parity 1-6 and gestational age 31-41 weeks, who developed or were admitted with primary postpartum haemorrhage due to uterine atony in whom medical treatment had failed. SPSS 10 was used to analyse the data. Results: The mean age, parity, gestational age of 139 women was 26.4±4.2 years, 3.4±1.3, 37.81±1.67 respectively. Mean estimated blood loss was 1155.8±350.6 ml, mean systolic blood pressure 90.96±18.1 mmHg, diastolic blood pressure 55±7.5 mmHg and mean pulse was 108.3±10.89 bpm. Balloon tamponade was effective in 126(90.4%) cases. Conclusion: Condom catheter balloon tamponade was an effective means of controlling postpartum haemorrhage. There should be a low threshold for use of balloon tamponade as it is effective, easy to use, easily available, has low complication rate, and an inexpensive modality to manage non-traumatic postpartum haemorrhage, especially in resource-limited settings, and still maintain reproductive ability. Keywords: Postpartum haemorrhage, PPH, Balloon tamponade. (JPMA 66: 22; 2016) Department of Obstetrics & Gynaecology, Unit II, 1,4 Dow Medical College and Civil Hospital Karachi, 2,3 DowUniversityofHealthSciences,Karachi. Correspondence: Gulfishan Haq. Email: gultariq2001@gmail.com