Chelli D, Boudaya F, Dimassi K, Gharbi B, Najjar I, Sfar E, Chanoufi M B, Chelli H
Service << A >> du centre de maternité et de néonatologie, La Rabta, 1007 Tunis, Tunisie.
J Gynecol Obstet Biol Reprod (Paris). 2010 Feb;39(1):43-9. doi: 10.1016/j.jgyn.2009.10.002. Epub 2009 Dec 3.
Post-partum hemorrhage is the leading cause of maternal mortality in Tunisia as in many other countries. In case of failure of medical measures, bilateral ligation of hypogastric arteries (BLHA) represents an interesting alternative to the hemostatic hysterectomy to preserve patients fertility.
Report our BLHA experience in the post-partum hemorrhage management.
Retrospective study conducted between January 2001 and December 2008. We collected all the patients who had undergone a BLHA in case of post-partum haemorrhage.
Fifty-seven BLHA were carried out during the study period. The success rate was 82.45%. The procedure failed in 10 patients. Most cases were uterine atony and placenta accreta. We reported one complication: a case of perioperative ligation of the primitive iliac artery. Surgical management was successful. Magnetic resonance imaging performed on average two months after surgery had shown a complete repermeabilization in seven cases among eight.
BLHA is an interesting and effective option in the management of severe post-partum hemorrhage. Technique learning is recommended especially in case of non availability of uterine artery embolization.
与许多其他国家一样，产后出血是突尼斯孕产妇死亡的主要原因。在医疗措施无效的情况下，双侧髂内动脉结扎术（BLHA）是一种有趣的替代止血性子宫切除术的方法，可保留患者的生育能力。
报告我们在产后出血管理中应用BLHA的经验。
对2001年1月至2008年12月期间进行的回顾性研究。我们收集了所有在产后出血时接受BLHA的患者。
在研究期间共进行了57例BLHA。成功率为82.45%。该手术在10例患者中失败。大多数病例为子宫收缩乏力和胎盘植入。我们报告了1例并发症：1例围手术期结扎原始髂动脉。手术处理成功。术后平均两个月进行的磁共振成像显示，8例中有7例完全再通。
BLHA是治疗严重产后出血的一种有趣且有效的选择。建议学习该技术，尤其是在无法进行子宫动脉栓塞的情况下。
