Kehila Mehdi, Derouich Sadok, Chelli Dalenda, Touhami Omar, Marzouk Sofiene Ben, Khedher Sonia Ben, Chanoufi Mohamed Bedis, Boudaya Fethia
Service C, Centre de Maternité et de Néonatologie de Tunis, Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie.
Service A, Centre de Maternité et de Néonatologie de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunisie.
Pan Afr Med J. 2016 Oct 18;25:96. doi: 10.11604/pamj.2016.25.96.9242. eCollection 2016.
The objective were to identify the success factors of bilateral hypogastric arteries ligation and to assess its role in surgical treatment of postpartum hemorrhages. We conducted a retrospective study of all the cases of postpartum hemorrhage requiring surgical treatment between January 2008 and December 2011. The study included 88 patients (0,47% of all births). Uterine atony was the most common etiology (64,8 % of patients). Bilateral ligation of the hypogastric arteries was performed in 81.8% of patients. When surgery was the first choice treatment, its success rate was 66%. This rate was variable depending on the etiology of hemorrhage, the presence or the absence of hemostasis disorders and the time between diagnosis and surgical treatment. In case of uterine atony, the association with a second conservative technique, when the first was inadequate, helped stop the bleeding in 98% of cases. Ligation of hypogastric arteries is an effective surgical technique for the treatment of postpartum hemorrhage. Its success rate has increased thanks to early implementation and to the association with other conservative techniques.
目的是确定双侧髂内动脉结扎的成功因素，并评估其在产后出血外科治疗中的作用。我们对2008年1月至2011年12月期间所有需要外科治疗的产后出血病例进行了回顾性研究。该研究包括88例患者（占所有分娩的0.47%）。子宫收缩乏力是最常见的病因（占患者的64.8%）。81.8%的患者进行了双侧髂内动脉结扎。当手术作为首选治疗方法时，其成功率为66%。该成功率因出血病因、是否存在止血障碍以及诊断与手术治疗之间的时间而异。在子宫收缩乏力的情况下，当第一种保守技术不足时，与第二种保守技术联合使用可使98%的病例止血。髂内动脉结扎是治疗产后出血的一种有效外科技术。由于早期实施以及与其他保守技术联合使用，其成功率有所提高。
