Çetin Berna Aslan, Aydogan Mathyk Begum, Atis Aydin Alev, Koroglu Nadiye, Yalcin Bahat Pinar, Temel Yuksel Ilkbal, Topcu Elif Goknur, Ozdemir Ismail
a Department of Obstetrics and Gynecology , Kanuni Sultan Suleyman Research and Training Hospital , Istanbul , Turkey.
b Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology , University of North Carolina , Chapel Hill , NC , USA.
J Matern Fetal Neonatal Med. 2019 Sep;32(18):3034-3038. doi: 10.1080/14767058.2018.1455184. Epub 2018 Apr 2.
Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality around the world. Medical treatments and uterus-sparing interventions including balloon tamponades and compression sutures are the first line options before the decision is made to perform a hysterectomy. Our aim is to compare the success rates of the Hayman compression suture and the Bakri balloon tamponade (BBT) in patients with PPH. We enrolled 82 patients who were diagnosed with uterine atony during their cesarean sections and failed to respond to uterotonic agents. The patients were treated with either a Hayman suture or a BBT. The success rates of the both methods were similar (76.7% in the Hayman group and 74.4% in the BBT group). In both groups, the success rate increased with the addition of artery ligations (93% in the Hayman group and 87.2% in the BBT). The Hayman suture and the BBT's performances were identical in the management of PPH due to uterine atony. All methods have pros and cons and the choice of the intervention depends on a variety of factors including the severity of bleeding, experience of the surgeon and the accessibility of the tools.
产后出血（PPH）是全球孕产妇发病和死亡的主要原因之一。在决定进行子宫切除术前，包括球囊填塞和压迫缝合在内的药物治疗和保留子宫的干预措施是一线选择。我们的目的是比较海曼压迫缝合术和巴克里球囊填塞术（BBT）在产后出血患者中的成功率。我们纳入了82例在剖宫产术中被诊断为宫缩乏力且对宫缩剂无反应的患者。这些患者接受了海曼缝合术或BBT治疗。两种方法的成功率相似（海曼组为76.7%，BBT组为74.4%）。在两组中，增加动脉结扎后成功率均有所提高（海曼组为93%，BBT组为87.2%）。在因宫缩乏力导致的产后出血管理中，海曼缝合术和BBT的表现相同。所有方法都有优缺点，干预措施的选择取决于多种因素，包括出血的严重程度、外科医生的经验和工具的可及性。
