Kuhn Theresa, Martimucci Kristina, Al-Khan Abdulla, Bilinski Robyn, Zamudio Stacy, Alvarez-Perez Jesus
Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey.
Department of Maternal Fetal Medicine, Hackensack University Medical Center, Hackensack, New Jersey.
AJP Rep. 2018 Apr;8(2):e142-e145. doi: 10.1055/s-0038-1666793. Epub 2018 Jun 28.
To evaluate if prophylactic hypogastric artery ligation (HAL) decreases surgical blood loss and blood products transfused. This is a retrospective cohort study comparing patients with placenta percreta undergoing prophylactic HAL at the time of cesarean hysterectomy versus those who did not. Data were presented as means ± standard deviations, proportions, or medians with interquartile ranges. Demographic and clinical data were compared in the groups using Student's -test for normally distributed data or the Mann-Whitney test for nonnormally distributed data. Fisher's exact test was used for proportions and categorical variables. Data are reported as significant where was <0.05. There were 26 patients included in the control group with no HAL and 11 patients included in the study group. Estimated blood loss for the study group was 1,000 mL versus 800 mL in the control. Units of PRCBs transfused were 4.5 units in the study group versus 2 units for the control group. None of these measures were found to be statistically significant. Our data suggest there was no benefit in the use of prophylactic HAL in decreasing surgical blood loss or amount of blood products transfused in patients who had a cesarean hysterectomy performed for placenta percreta. Prophylactic HAL does not decrease blood loss during surgery for placenta percreta.
评估预防性髂内动脉结扎术（HAL）是否能减少手术失血量及输血量。 这是一项回顾性队列研究，比较了剖宫产子宫切除术中接受预防性HAL的胎盘植入患者与未接受该手术的患者。数据以均值±标准差、比例或四分位间距的中位数表示。使用Student's t检验对正态分布数据进行组间人口统计学和临床数据比较，对非正态分布数据使用Mann-Whitney U检验。对比例和分类变量使用Fisher精确检验。当P<0.05时，数据被报告为具有统计学意义。 对照组有26例未接受HAL的患者，研究组有11例患者。研究组的估计失血量为1000 mL，而对照组为800 mL。研究组输注的红细胞悬液单位数为4.5单位，对照组为2单位。这些指标均未发现具有统计学意义。 我们的数据表明，对于因胎盘植入而行剖宫产子宫切除术的患者，预防性使用HAL在减少手术失血量或输血量方面并无益处。 预防性HAL并不能减少胎盘植入手术中的失血量。
