| | Advantages | Disadvantages |
| Balloon tamponade | - Relatively easy to insert
- Can place through the hysterotomy at cesarean birth or using a vaginal approach
- Uses a single device, which reduces the risk of a retained foreign body
- Allows monitoring of ongoing intrauterine bleeding (specially designed balloons)
| - Potential for balloon displacement/expulsion
- Potential for catheter occlusion by clot
- Discomfort from uterine distension by the balloon
- Longer dwell time
|
| Intrauterine vacuum | - Advantages are similar to those of balloon tamponade (except for placement through the hysterotomy) plus:
- Rapid onset of action and shorter dwell time
- Collapse rather than distension of the intrauterine cavity, resulting in potentially shorter duration of use
| - Cannot be used when the cervix is <3 cm dilated
- Cannot be placed through the hysterotomy at cesarean birth
- More expensive than other methods
|
| Gauze packing | - Generally inexpensive
- Readily available in most settings
- Specialized gauze that is impregnated with hemostatic agents (eg, kaolin, chitosan) may provide additional benefit
| - Potentially requires a longer time to fully insert gauze compared with other methods
- Blood is absorbed into the fabric, which may mask ongoing bleeding
- Risk of a retained foreign body (especially when more than one pack is required)
- The pack must be placed so that it exerts sufficient pressure through the uterine cavity, which is essential for success (especially for plain gauze)
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