Uterine-sparing surgical management of postpartum hemorrhage: is it always effective?

被引：10

作者：

Blanc, Julie ^{[1
]}

Courbiere, Blandine ^{[2
,3
]}

Desbriere, Raoul ^{[1
]}

Bretelle, Florence ^{[1
,3
]}

Boubli, Leon ^{[1
,3
]}

D'Ercole, Claude ^{[1
,3
]}

Carcopino, Xavier ^{[1
,3
]}

机构：

[1] Hop Nord Marseille, Dept Obstet & Gynecol, Assistance Publ Hop Marseille APHM, F-13915 Marseille 20, France

[2] Hop Conception, Dept Obstet & Gynecol, APHM, F-13005 Marseille, France

[3] Univ Mediterranae, Fac Med Marseille, F-13385 Marseille 05, France

来源：

ARCHIVES OF GYNECOLOGY AND OBSTETRICS | 2012年 / 285卷 / 04期

关键词：

Postpartum hemorrhage; Surgery; Placenta accreta; Cesarean section; CONSERVATIVE TREATMENT; PLACENTA-ACCRETA; UNITED-STATES; DEVASCULARIZATION; FERTILITY;

D O I：

10.1007/s00404-011-2083-7

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

To further study the efficacy of uterine-sparing procedures based on triple uterine artery ligation (TUAL) possibly complemented with hemostatic multiple square suturing (HMSS) for the management of post-partum hemorrhage (PPH). Cases of PPH occurring during cesarean section and treated, according to our institution guidelines, by TUAL possibly complemented with HMSS between 2000 and 2009 were retrospectively analyzed. Fifty-six patients were included; 13 (23.2%) had TUAL only, while 43 (76.8%) had additional HMSS performed. Surgical conservative management of PPH was effective in 51 (91.1%) cases. PPH due to placenta accreta, either unanticipated or after failure of conservative management, showed an independent and significant impact on the risk of failure of the procedure (AOR 15.07, 95% CI 1.12-201.9, p = 0.041). Obstetricians should be aware that a higher risk of failure of the procedure is to be expected in cases of PPH due to placenta accreta. In such situation, to avoid any useless delay in management, our findings suggest that peripartum hysterectomy should be immediately considered.

引用

页码：925 / 930

页数：6