Liu S, Mathur M, Tagore S
Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital , Singapore.
J Obstet Gynaecol. 2014 Jul;34(5):383-6. doi: 10.3109/01443615.2014.895309. Epub 2014 Mar 28.
In the treatment of postpartum haemorrhage from uterine atony, uterine compression sutures, such as the B-Lynch suture and its modifications have a role with the advantage of preservation of the uterus for fertility. There is however, a risk that apposition of the anterior and posterior walls of the uterus will impede drainage of lochia, resulting in undesirable complications. We undertook a five-year retrospective study of all women who underwent uterine compression sutures at the KK Women's and Children's Hospital, between 2008 and 2012. In total, 23 women had uterine compression sutures during the study period, of which, nineteen women managed to conserve their uterus. Our complication rate was 25%, which included persistent vaginal discharge, pyometra and endometritis. There were three conceptions, with two successful pregnancies. Our study shows uterine compression suture to be a safe and effective alternative to avoid hysterectomy with preservation of fertility at the time of major postpartum haemorrhage. The outcome of subsequent pregnancies is reassuring.
在治疗子宫收缩乏力引起的产后出血时,子宫压迫缝合术,如B-Lynch缝合术及其改良术式,具有保留子宫生育功能的优势。然而,子宫前后壁贴合存在阻碍恶露引流的风险,可能导致不良并发症。我们对2008年至2012年间在KK妇女儿童医院接受子宫压迫缝合术的所有女性进行了一项为期五年的回顾性研究。在研究期间,共有23名女性接受了子宫压迫缝合术,其中19名女性成功保留了子宫。我们的并发症发生率为25%,包括持续性阴道分泌物、积脓和子宫内膜炎。有3例受孕,其中2例成功妊娠。我们的研究表明,子宫压迫缝合术是一种安全有效的替代方法,可避免在严重产后出血时进行子宫切除术并保留生育功能。后续妊娠的结果令人放心。