双侧子宫动脉结扎术联合 B-Lynch 术治疗胎盘植入性产后出血伴宫缩乏力。
Bilateral uterine artery ligation plus B-Lynch procedure for atonic postpartum hemorrhage with placenta accreta.
机构信息
Department of Obstetrics and Gynecology, Women's Health Centre, Assiut University, Egypt.
出版信息
Int J Gynaecol Obstet. 2010 Mar;108(3):187-90. doi: 10.1016/j.ijgo.2009.08.035. Epub 2009 Nov 27.
OBJECTIVE
To assess the effectiveness of bilateral uterine artery ligation followed by B-Lynch compression suturing in women with atonic postpartum hemorrhage and placental site bleeding due to adherent placenta accreta.
METHOD
This protocol was followed in 26 women undergoing cesarean delivery for placenta accreta.
RESULTS
Two women died from disseminated intravascular coagulopathy. In the remaining 24 women, placental remnants completely disappeared within 8 months and ovulation resumed after a mean+/-SD of 51.6+/-3.2 days. Moreover, 18 women (75%) became pregnant within 12 months.
CONCLUSION
Atonic postpartum hemorrhage and placental site bleeding due to adherent placenta accreta can be safely controlled by bilateral uterine artery ligation followed by B-Lynch compression suturing in women who desire to remain fertile.
目的
评估在有生育要求的患者中，采用双侧子宫动脉结扎联合 B-Lynch 压缩缝合术治疗因粘连性胎盘植入导致的宫缩乏力性产后出血和胎盘附着部位出血的效果。
方法
本方案纳入了 26 例行剖宫产术治疗胎盘植入的患者。
结果
有 2 名患者死于弥漫性血管内凝血。在其余 24 名患者中，胎盘残留组织在 8 个月内完全消失，排卵恢复时间的平均值+/-标准差为 51.6+/-3.2 天。此外，18 名患者（75%）在 12 个月内怀孕。
结论
对于有生育要求的患者，采用双侧子宫动脉结扎联合 B-Lynch 压缩缝合术可以安全地控制因粘连性胎盘植入导致的宫缩乏力性产后出血和胎盘附着部位出血。
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