Hussein Ahmed M, Dakhly Dina Mohamed Refaat, Raslan Ayman N, Kamel Ahmed, Abdel Hafeez Ali, Moussa Manal, Hosny Ahmed Samir, Momtaz Mohamed
a Department of Obstetrics and Gynaecology , Cairo University , Cairo , Egypt.
b Department of Vascular Surgery , Cairo University , Cairo , Egypt.
J Matern Fetal Neonatal Med. 2019 Oct;32(20):3386-3392. doi: 10.1080/14767058.2018.1463986. Epub 2018 Apr 25.
To identify the role of bilateral internal iliac artery (IIA) ligation on reducing blood loss in abnormally invasive placenta (AIP) undergoing caesarean hysterectomy. In this parallel-randomized control trial, 57 pregnant females with ultrasound features suggestive of AIP were enrolled. They were randomized into two groups; IIA group ( = 29 cases) performed bilateral IIA ligation followed by caesarean hysterectomies, while Control group ( = 28 cases) underwent caesarean hysterectomy only. The main outcome was the difference in the estimated intraoperative blood loss between the two groups. There was no significant difference between the two groups regarding the intraoperative estimated blood loss (1632 ± 804 versus 1698 ± 1251, value .83). The operative procedure duration (minutes) (223 ± 66 versus 171 ± 41.4, value .001) varied significantly between the two groups. Bilateral internal iliac artery ligation, in cases of AIP undergoing caesarean hysterectomy, is not recommended for routine practice to minimize blood loss intraoperatively.
确定双侧髂内动脉结扎在剖宫产子宫切除术中对减少异常侵入性胎盘(AIP)出血方面的作用。在这项平行随机对照试验中,纳入了57例具有超声特征提示AIP的孕妇。她们被随机分为两组;髂内动脉组(n = 29例)先进行双侧髂内动脉结扎,然后行剖宫产子宫切除术,而对照组(n = 28例)仅行剖宫产子宫切除术。主要结局是两组间估计术中失血量的差异。两组间术中估计失血量无显著差异(1632±804与1698±1251,P值0.83)。两组间手术操作时间(分钟)(223±66与171±41.4,P值0.001)差异显著。对于行剖宫产子宫切除术的AIP病例,不建议常规进行双侧髂内动脉结扎以尽量减少术中失血。