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剖宫产术中使用宫颈止血带减少胎盘植入患者出血的初步研究

Cervical tourniquet during cesarean section to reduce bleeding in morbidly adherent placenta: a pilot study.

作者信息

Altal Omar F, Qudsieh Suhair, Ben-Sadon Abeer, Hatamleh Assala, Bataineh Adel, Halalsheh Omar, Amarin Zouhir

机构信息

Department of Obstetrics & Gynecology, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan.

Department of Clinical Science/Obstetrics & Gynecology, Faculty of Medicine, Yarmouk University, Irbid, 21163, Jordan.

出版信息

Future Sci OA. 2022 Mar 8;8(4):FSO789. doi: 10.2144/fsoa-2021-0087. eCollection 2022 Apr.

DOI:10.2144/fsoa-2021-0087
PMID:35369280
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8965796/
Abstract

OBJECTIVE

To evaluate a modified surgical technique aiming to reduce bleeding and preserve fertility in morbidly adherent placenta by cervical tourniquet in cesarean sections.

METHODS

The cesarean section operations and the cervical ligation approach were performed by a single expert consultant obstetrician. The general demographics and clinical characteristics for all participants were collected and studied.

RESULTS

Eleven participants were involved. The uterus was preserved in nine patients, whereas two patients had hysterectomy. The mean blood loss was 1688.8 ml for patients whose uterus was preserved. The mean length of stay was 5.5 days.

CONCLUSION

Cervical ligation is a simple method that can be applied by junior and experienced obstetricians to preserve the uterus.

摘要

目的

评估一种改良手术技术,旨在通过剖宫产术中使用宫颈止血带减少凶险性前置胎盘的出血并保留生育能力。

方法

剖宫产手术及宫颈结扎方法由一位资深产科专家顾问实施。收集并研究所有参与者的一般人口统计学和临床特征。

结果

共纳入11名参与者。9例患者子宫得以保留,而2例患者进行了子宫切除术。子宫得以保留的患者平均失血量为1688.8毫升。平均住院时间为5.5天。

结论

宫颈结扎是一种简单的方法,初级和经验丰富的产科医生均可应用以保留子宫。

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Placenta accreta spectrum: a hysterectomy can be prevented in almost 80% of cases using a resective-reconstructive technique.胎盘植入谱系疾病:采用切除术-重建术,近 80%的病例可避免子宫切除术。
J Matern Fetal Neonatal Med. 2022 Jan;35(2):275-282. doi: 10.1080/14767058.2020.1716715. Epub 2020 Jan 26.
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Alternative approaches to surgical hemostasis in patients with morbidly adherent placenta undergoing fertility-sparing surgery.对于患有胎盘植入的患者,在进行保留生育功能手术时,手术止血的替代方法。
J Matern Fetal Neonatal Med. 2019 Jun;32(12):2042-2048. doi: 10.1080/14767058.2018.1424821. Epub 2018 Feb 5.
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Antecedents of Abnormally Invasive Placenta in Primiparous Women: Risk Associated With Gynecologic Procedures.
初产妇异常胎盘前置的病因:与妇科手术相关的风险。
Obstet Gynecol. 2018 Feb;131(2):227-233. doi: 10.1097/AOG.0000000000002434.
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Two-tourniquet sequential blocking as a simple intervention for hemorrhage during cesarean delivery for placenta previa accreta.双止血带序贯阻断术作为前置胎盘植入剖宫产术中出血的一种简单干预措施。
Int J Gynaecol Obstet. 2017 Sep;138(3):361-362. doi: 10.1002/ijgo.12199. Epub 2017 Jun 13.
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The cervix as a natural tamponade in postpartum hemorrhage caused by placenta previa and placenta previa accreta: a prospective study.子宫颈作为前置胎盘和胎盘植入所致产后出血的天然压迫物:一项前瞻性研究。
BMC Pregnancy Childbirth. 2015 Nov 11;15:295. doi: 10.1186/s12884-015-0731-9.
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Conservative management of morbidly adherent placenta: expert review.胎盘植入的保守治疗:专家综述
Am J Obstet Gynecol. 2015 Dec;213(6):755-60. doi: 10.1016/j.ajog.2015.04.034. Epub 2015 Apr 30.
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Maternal serum markers, characteristics and morbidly adherent placenta in women with previa.前置胎盘孕妇的血清标志物、特征与胎盘粘连
J Perinatol. 2015 Aug;35(8):570-4. doi: 10.1038/jp.2015.40. Epub 2015 Apr 30.
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Recent trends in placenta accreta in the United States and its impact on maternal-fetal morbidity and healthcare-associated costs, 1998-2011.1998 - 2011年美国胎盘植入的近期趋势及其对母婴发病率和医疗相关成本的影响
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