Limbachiya Dipak, Kenkre Mangirish, Shah Siddharth, Kumari Rashmi, Desai Hardik D
Department of Gynecology, Eva Women's Hospital, Ahmedabad, IND.
Internal Medicine, Gujarat Adani Institute of Medical Sciences, Bhuj, IND.
Cureus. 2021 Jan 25;13(1):e12892. doi: 10.7759/cureus.12892.
Postpartum hemorrhage (PPH) is associated with considerable morbidity and mortality, particularly when relaparotomy is necessary. The etiology of spontaneous intractable PPH in a hemodynamically stable patient is poorly understood and remains open to speculation. Secondary, or delayed, PPH is usually defined as the excessive bleeding from the genital tract, with a loss of 500 ml or more of blood occurring after the first 24 hours after delivery until the sixth week of puerperium. In this report, we present three cases of severe, diffuse postpartum bleeding unresponsive to conventional hemostatic measures, which were successfully managed laparoscopically at our center. In all three cases, hemostasis was accomplished by using a laparoscopic procedure: with the excision of cervical stump bleeding in the first case, bilateral uterine artery ligation accompanied by laparoscopic hysterectomy in the second case, and bilateral internal iliac artery ligation in the third case.
产后出血（PPH）与相当高的发病率和死亡率相关，尤其是在需要再次剖腹手术时。血流动力学稳定的患者发生自发性难治性产后出血的病因尚不清楚，仍有待推测。继发性或延迟性产后出血通常定义为生殖道大量出血，在分娩后24小时至产褥期第六周期间失血500毫升或更多。在本报告中，我们介绍了三例严重、弥漫性产后出血的病例，这些病例对传统止血措施无效，在我们中心通过腹腔镜手术成功治疗。在所有三例病例中，均通过腹腔镜手术实现止血：第一例为切除宫颈残端出血，第二例为双侧子宫动脉结扎并伴有腹腔镜子宫切除术，第三例为双侧髂内动脉结扎。
