Atilgan Remzi, Ozkan Zehra Sema, Orak Ugur, Baspinar Melike
Fırat University, Elazig, Turkey.
Department of Obstetrics and Gynaecology, Fırat University Faculty of Medicine, Elazig, Turkey.
BMJ Case Rep. 2014 Dec 1;2014:bcr2014205872. doi: 10.1136/bcr-2014-205872.
A 30-year-old, 39 weeks pregnant, multiparous woman with single fetus, attended our obstetric clinic with complete cervical dilation in intractable mentum anterior presentation. The fetus was delivered by caesarean section with vertical uterine incision under general anaesthesia and lithotomy position. After surgery, examination of the vagina revealed multiple, serious tears with severe haemorrhage. Vaginal bleeding could not be controlled by sutures and concurrently uterine atony developed, which could not be controlled with medical treatment. Owing to intractable bleeding from uterus and vagina, a complete tamponade system was used. After the instillation of the uterine balloon with 500 mL and vaginal balloon with 300 mL liquid, the bleeding was controlled. The estimated blood loss was 3200 mL. The vaginal wound healed well during the postoperative 2 weeks. A complete tamponade system may be an effective treatment method for treatment of postpartum haemorrhage owing to vaginal lacerations and uterine atony.
一名30岁、孕39周、经产妇、单胎妊娠的妇女因持续性颏前位、宫颈完全扩张而前来我们的产科门诊。在全身麻醉和截石位下,通过子宫纵切口剖宫产娩出胎儿。术后检查阴道发现多处严重撕裂伤并伴有大量出血。缝合无法控制阴道出血,同时出现子宫收缩乏力,药物治疗也无法控制。由于子宫和阴道出血难以控制,使用了一套完整的填塞系统。向子宫球囊注入500毫升液体、向阴道球囊注入300毫升液体后,出血得到控制。估计失血量为3200毫升。术后2周阴道伤口愈合良好。一套完整的填塞系统可能是治疗因阴道撕裂伤和子宫收缩乏力引起的产后出血的有效治疗方法。