Department of Obstetrics and Gynecology, Chung-Ang University, Seoul, Korea.
J Perinat Med. 2011 Jul;39(4):477-81. doi: 10.1515/jpm.2011.029.
A supracervical cerclage suturing technique with an intracavitary balloon (SCCB) was developed to simultaneously compress bleeding from the placental bed and the outside uterine wall.
Twenty cesarean sections were performed due to placenta previa over three years. The SCCB was used in 13 patients with uncontrolled bleeding after failure of conventional methods. The conventional surgical hemostatic techniques were applied first in patients with copious bleeding due to placenta previa. If bleeding continued, a three-way Foley catheter was inserted into the uterine cavity through the cervix and SCCB was performed. About 50-100 mL of normal saline was infused to inflate the catheter balloon. On the next morning, attempts were made to withdraw the F-catheter but if bleeding started again, another 12 h of pressure was provided.
The mean removal time for the intracavitary Foley catheter was 20.6±12.3 h. There was one case of subtotal hysterectomy after the SCCB. All patients were followed for at least 12 months. There were no specific complications related to the procedure. All women returned to their normal menstrual cycles and one had an ongoing third trimester pregnancy.
The SCCB is a simple and effective technique to control bleeding associated with placenta previa.
一种经宫颈宫腔内球囊（SCCB）的宫颈环扎缝合技术被开发出来，以同时压迫胎盘床和子宫外壁的出血。
三年间因前置胎盘而行剖宫产术 20 例。13 例前置胎盘出血患者经传统方法治疗无效后采用 SCCB。对于因前置胎盘而大量出血的患者，首先采用传统的手术止血技术。如果出血持续，通过宫颈将三腔 Foley 导管插入宫腔，并进行 SCCB。向导管球囊内注入约 50-100mL 的生理盐水使其膨胀。次日早晨，尝试拔出 F 型导管，但如果再次出血，则再次提供 12 小时的压力。
宫腔内 Foley 导管的平均取出时间为 20.6±12.3 小时。SCCB 后有 1 例患者行次全子宫切除术。所有患者均至少随访 12 个月。无与该操作相关的特定并发症。所有女性均恢复正常月经周期，其中 1 例妊娠进入第三孕期。
SCCB 是一种控制前置胎盘相关出血的简单有效技术。
