Seidel Vera, Braun Thorsten, Weizsäcker Katharina, Henrich Wolfgang
Department of Obstetrics, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178 Berlin, Germany.
Department of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Germany.
Int J Surg Case Rep. 2018;48:101-103. doi: 10.1016/j.ijscr.2018.05.006. Epub 2018 May 26.
Postpartum or peripartum hemorrhage (PPH) is a major cause of maternal death worldwide. Fertility preserving second stage interventions following uterotonic medications may include compression sutures, uterine balloon tamponade and ligation or embolization of arteries.
We present a case of PPH where a novel "uterine sandwich" approach (combination of chitosan-covered gauze with intrauterine balloon tamponade) was effectively used to stop further blood loss and prevented more invasive second stage interventions. Furthermore, we present the ultrasonographic image of chitosan-covered gauze in the uterine cavity.
Chitosan-covered gauze and intrauterine balloon tamponade are complementary in their mechanism of work, the balloon reducing blood flow into the uterus and the chitosan-covered gauze enhancing the coagulation.
This novel "uterine sandwich" approach can be a useful method for fertility preserving management of PPH.
产后或围产期出血（PPH）是全球孕产妇死亡的主要原因。在使用宫缩剂后进行的保留生育功能的第二阶段干预措施可能包括压迫缝合、子宫球囊填塞以及动脉结扎或栓塞。
我们报告一例产后出血病例，其中一种新型的“子宫三明治”方法（壳聚糖包裹纱布与宫腔球囊填塞相结合）有效地用于阻止进一步失血，并避免了更具侵入性的第二阶段干预措施。此外，我们展示了宫腔内壳聚糖包裹纱布的超声图像。
壳聚糖包裹纱布和宫腔球囊填塞在工作机制上具有互补性，球囊减少子宫内的血流，而壳聚糖包裹纱布增强凝血功能。
这种新型的“子宫三明治”方法可能是一种有用的保留生育功能的产后出血管理方法。
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