Vacuum-induced and balloon tamponade devices perform similarly for postpartum hemorrhage

Vacuum-induced and balloon tamponade devices demonstrated comparable performance across most outcomes in the treatment of postpartum hemorrhage (PPH), though the vacuum device was favored on 3 measures, according to a poster presented at the 2026 American College of Obstetricians & Gynecologists (ACOG) Annual Clinical & Scientific Meeting. In an interview conducted at the meeting, 2 of the study's authors discussed the findings from the poster, "Vacuum-Induced Compared With Balloon Tamponade Devices for Postpartum Hemorrhage: A Systematic Review and Meta-Analysis.

Meg Vasey, MD candidate, New York Medical College, Valhalla, New York, outlined the scope of the analysis, which screened 2,283 abstracts and included 85 single-arm and comparative studies (5 vacuum, 63 balloon, 4 comparative). Per the abstract, there were no significant differences in device failure (9.0%), escalation to hysterectomy (5%), tranexamic acid use (81%), length of admission, or blood loss.

"We found that the devices performed similarly across most of the outcomes… but notably, there were 3 outcomes where the vacuum device was favored; a shorter indwelling time, lower rates of ICU admission, and lower rates of blood transfusion," Vasey said.

According to the abstract, the vacuum device showed lower ICU admission (5% vs 12%, P < .001), lower blood transfusion rates (48% vs 62%, P < .001), and shorter indwelling time by 1.96 hours (P < .001), consistent across vaginal (1.36 hours, P ≤ .001) and cesarean deliveries (1.70 hours, P < .01).

Anubha Arora, MD, board-certified OB-GYN, New York Medical College, Valhalla, New York, framed the takeaway while emphasizing patient selection and the need for stronger evidence.

"From our systematic review, the conclusion was that both devices are equally effective, but of course clinicians should see the whole clinical picture and find the right patient to use both of these devices," she said, adding that the vacuum device's shorter indwelling time "could be something that clinicians should start thinking about as a tool in their toolbox to use at a much earlier stage when they're dealing with postpartum hemorrhage."

Arora cautioned that most included studies were comparative rather than prospective, introducing potential bias. Because balloon tamponade has been standard for 2 decades, "there's always a chance that the patients who did get balloon tamponade were the ones who actually had more severe postpartum hemorrhage," she said.

In the future, randomized data will be needed to confirm any true difference, according to the authors.

Reference:

Vasey, M, Arora A, Godinich BM, et al. Vacuum-Induced Compared With Balloon Tamponade Devices for Postpartum Hemorrhage: A Systematic Review and Meta-Analysis. Poster. Presented at: American College of Obstetricians & Gynecologists Annual Clinical & Scientific Meeting. May 1-3, 2026. Washington, D.C.