Tsvetkov K, Angelova M, Monastirska M, Tsvetkov Ts
Akush Ginekol (Sofiia). 2008;47(5):34-7.
Bleedings are the leading cause for mother's mortality rate worldwide and that is why the authors face once more the abdominal operative methods for definite copying the early post partum haemorrhages (EPH). They share their experience gained already with 46 cases when EPH has definitively been copied by means of stepwise uterine devascularization of the vessels with atonic bleedings and ligation of a. iliaca interna presenting with laceration of the lower uterine segment and vagina as well. Hysterectomy has been performed only when the uterus has already exhausted its fertile capacities in a structural and functional aspect, e.g. after numerous abortions, deliveries and experienced Caesarean sections, intra-partum septic conditions, appoplexio uteri, etc. According to authors' opinion, the stepwise uterine devascularization is the method of choice for EPH surgical copying during which woman' fertility is, in fact, preserved. With this method, no complications typical of the various compression methods applied to overcome the puerperal bleedings such as B-Linch sutures, haemostatic sutures of 'multiple squares' type as well as U-shape compression sutures have been observed at all.
出血是全球孕产妇死亡率的主要原因，这就是作者再次面对腹部手术方法以确切模拟产后早期出血（EPH）的原因。他们分享了46例的经验，在这些病例中，通过逐步对无张力性出血的血管进行子宫去血管化以及对伴有子宫下段和阴道裂伤的髂内动脉进行结扎，已确切模拟了产后早期出血。仅当子宫在结构和功能方面已耗尽其生育能力时，例如在多次流产、分娩和剖宫产、产时败血症、子宫卒中等等之后，才进行子宫切除术。根据作者的观点，逐步子宫去血管化是模拟产后早期出血手术的首选方法，实际上这种方法能保留女性的生育能力。使用这种方法时，未观察到用于克服产后出血的各种压迫方法（如B-Lynch缝合、“多个方块”型止血缝合以及U形压迫缝合）所特有的并发症。
