Liu Congcong, Gao Jinsong, Liu Juntao, Wang Xietong, He Jing, Sun Jingxia, Liu Xiaowei, Liao Shixiu
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
Front Med (Lausanne). 2021 Jul 15;8:656422. doi: 10.3389/fmed.2021.656422. eCollection 2021.
To identify the factors predicting intrauterine balloon tamponade (IUBT) failure for severe postpartum hemorrhage (PPH) after delivery, we conducted a retrospective cohort study of women who underwent IUBT for severe PPH after delivery from October 1, 2016 until September 30, 2017. The failure of IUBT was defined as the need of additional surgical procedures or uterine embolization. A total of 99,650 deliveries occurred during the study period. Among the patients, 106 cases of severe PPH were managed with IUBT, and the global success rate was 70.8% (75/106). Least absolute shrinkage and selection operator (LASSO) regression was performed to select the potential risk factors predicting IUBT failure. The associated risk factors-obesity, multiple gestation, cesarean delivery, estimated blood loss (EBL), and placenta accreta spectrum (PAS)-were included in multivariate logistic models. Ultimately, these models identified multiple gestation, EBL, and PAS as independent risk factors for IUBT failure. In conclusion, IUBT is an effective method for severe PPH. The presence of factors affecting IUBT failure should be recognized early, and other modalities of management should be anticipated.
为了确定预测产后严重出血（PPH）行宫腔球囊填塞术（IUBT）失败的因素，我们对2016年10月1日至2017年9月30日期间因产后严重PPH而行IUBT的女性进行了一项回顾性队列研究。IUBT失败定义为需要额外的手术或子宫栓塞。研究期间共发生99,650例分娩。在这些患者中，106例严重PPH患者接受了IUBT治疗，总体成功率为70.8%（75/106）。采用最小绝对收缩和选择算子（LASSO）回归来选择预测IUBT失败的潜在风险因素。将相关风险因素——肥胖、多胎妊娠、剖宫产、估计失血量（EBL）和胎盘植入谱系（PAS）纳入多因素逻辑模型。最终，这些模型确定多胎妊娠、EBL和PAS为IUBT失败的独立风险因素。总之，IUBT是治疗严重PPH的有效方法。应尽早识别影响IUBT失败的因素，并预期其他治疗方式。
