Lau M S K, Tee J C S
Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899.
Singapore Med J. 2009 Sep;50(9):e321-3.
We describe the successful use of a balloon catheter in primary postpartum haemorrhage secondary to placenta praevia. A 29-year-old woman was admitted for cervical priming at 37 weeks. Antenatal screening ultrasonography showed a normally-sited placenta. During the surgical induction of labour, bleeding per vaginum was noted, and a mass was felt at the cervical os. Emergency caesarean section was performed, and a placenta praevia was confirmed. Upon reversal of general anaesthesia, vaginal bleeding was noted despite a well-contracted uterus. The estimated blood loss was 1,200 ml. A hydrostatic catheter was inserted vaginally into the uterine cavity. After 17 hours, it was removed with no vaginal bleeding. The insertion for the balloon catheter was easy and simple, requiring minimal analgesia, and it was without significant complication. As obstetricians become more confident in this technique, surgical intervention may be avoided. This may subsequently lead to a reduction in maternal morbidity and mortality.
我们描述了在前置胎盘继发的原发性产后出血中成功使用球囊导管的情况。一名29岁女性在37周时因宫颈准备入院。产前筛查超声显示胎盘位置正常。在引产手术过程中，发现阴道出血，宫颈口可触及一肿物。行急诊剖宫产，确诊为前置胎盘。全身麻醉苏醒后，尽管子宫收缩良好，但仍有阴道出血。估计失血量为1200毫升。经阴道将一根水压导管插入子宫腔。17小时后取出导管，阴道不再出血。球囊导管的插入操作简便，只需极少的镇痛，且无明显并发症。随着产科医生对该技术越来越有信心，可能避免手术干预。这随后可能会降低孕产妇的发病率和死亡率。
