Postpartum Hemorrhage · Uterine Suction Tamponade

A Foley catheter. Available anywhere.
used to stop postpartum hemorrhage.

The FOCUS Protocol delivers uterine suction tamponade using equipment already in every delivery room — no proprietary device required. Published in AJOG. Used globally.

View the Evidence →
FOCUS Protocol · 6 Steps Peer-Reviewed
01
Confirm Indication
Atonic uterus refractory to uterotonics and bimanual compression
02
Prepare the Foley Catheter
16–24 Fr; balloon in lower uterine segment
03
Connect Suction
Wall suction via standard tubing, 80 mmHg continuous no more than 525 mmHg
04
Confirm Hemostasis
Quantify blood loss; monitor output through catheter
05
Monitor
Continue uterotonics; consider administration of antibiotics
06
Deflate & Remove
Turn off the suction and remove the balloon after ≥1 hour confirmed hemostasis

Who uses the FOCUS Protocol?

Designed to work in any delivery setting, from tertiary university hospitals to rural community facilities, across every resource level.

🏥
OB/GYNs
🧬
MFMs & Perinatologists
👩‍⚕️
Midwives
📋
Family Medicine Physicians
💊
Family Planning Providers
🏛️
University Hospitals
🏤
Community Hospitals
🌍
Global & LMIC Providers

Indications & Contraindications

Proper patient selection is critical. Review these criteria before use.

Indications

When FOCUS is appropriate

Atonic PPH — Any Trimester
PPH due to uterine atony in the first, second, or third trimester of pregnancy.
After Cesarean or Vaginal Delivery
Can be used regardless of cervical dilation, following either delivery route.
Open Hysterotomy
Can be placed directly through an open hysterotomy incision during cesarean delivery.
Delayed Postpartum Hemorrhage
Applicable for delayed PPH occurring after the immediate postpartum period.
Contraindications

When FOCUS should not be used

Uterine Rupture
Placenta Accreta Spectrum
Traumatic Bleeding
Coagulopathy-Related Bleeding
Purulent Infection
Significant Retained Placental Tissue
Vaginal Hemorrhage from Non-Uterine Source
Never inflate beyond the manufacturer’s recommended volume. Proper diagnosis and exclusion of contraindications are critical to avoid delays in necessary surgical or systemic interventions.

Institutional Backbone

The TRUST Collaborative

TRUST (Tamponade Research for Uterine Suction Technique) is a global, multi-committee initiative structured to be institution-independent. Its mission: eliminate the technology and access barrier between an evidence-based PPH intervention and the provider who needs it.

Visit trustpph.com →
Technology Access
Education & Training
Research Coordination
Governmental Relations

Step-by-Step

Six steps. Any delivery room.
Any resource level.

The full illustrated guide is available in 10 languages as translated web guides. The steps below are a clinical summary — register to access the full bedside reference.

STEP 01

Confirm Indication

Atonic uterus refractory to uterotonics and bimanual compression

STEP 02

Prepare the Foley Catheter

16–24 Fr; balloon in lower uterine segment

STEP 03

Connect Suction

Wall suction via standard tubing, 80 mmHg continuous no more than 525 mmHg

STEP 04

Confirm Hemostasis

Quantify blood loss; monitor output through catheter

STEP 05

Monitor

Continue uterotonics; consider administration of antibiotics

STEP 06

Deflate & Remove

Turn off the suction and remove the balloon after ≥1 hour confirmed hemostasis

Get the protocol.
Ready for bedside use.

Register once to access all FOCUS materials. Select your language below.