A New Surgical Way to Face Postpartum Hemorrhage

• 作者: Barka Rabea Harbil Driss Lafkir Said Loutfi G. Abdelmounaim N. Biougnach Tmiri Adil
• 来源期刊: 妇产科期刊(英文)
• 学科: 医学
• 关键词: Postpartum: PPH Hemorrhage SURGICAL Technique UTERUS PLICATION Vascular LIGATION Hemostatic Hematometry Amenorrhea and Isthmocoele
• 年，卷（期）: fckqkyw_2020,（9）
• 页码范围: 1147-1155
• 页数: 9页
• 分类号: R65

摘要

<strong>Objective:</strong> <span style="font-family:""><span style="font-family:Verdana;">We introduced two novel hemostatic techniques to achieve hemostasis for postpartum hemorrhage (PPH). The first one (A: Uterus Isthmic Plication) was a new uterine compression suture, which compresses the hysterotomy site. In a severe case, we further added vessel ligation suture after </span><span style="font-family:Verdana;">performing A-suture (B-combination suture: B-suture: A + Wide Lateral Uterine </span><span style="font-family:Verdana;">Vascular Ligation). </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Of 140 PPH cases, 90 were with mild PPH and 40 were with severe PPH. Our policy was: perform A-suture to mild PPH and perform B (combination) to severe PPH. Study was performed during 2018-2019. The primary endpoint to evaluate the efficacy of the</span><span><span style="font-family:Verdana;"> procedures was preserving the uterus (no hysterectomy). </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A-procedure,</span></span><span style="font-family:Verdana;"> performed to 90 patients with mild PPH, was effective to all 90 patients, with all preserving the uterus. B-procedure, performed 38 patients with severe PPH (excluding two patients with uterine rupture), was effective in 37 patients, with one having undergone hysterectomy due to coagulopathy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Uterus Isthmic Plication (A-procedure) and addition of Wide Lateral Uterine Vascular Ligation to procedure-A (B-procedure) achieved hemostasis in patients with PPH. Prospective study is necessary to confirm the present data.</span></span>