Abul Ahmad, Al-Naseem Abdulrahman, Althuwaini Abdulwahab, Al-Muhanna Abdulredha, Clement Naomi S
School of Medicine, University of Leeds, Leeds, United Kingdom (XX Abul, XX Althuwaini, and XX Al-Muhanna).
School of Medical Sciences, University of Manchester, Manchester, United Kingdom (XX Al-Naseem).
AJOG Glob Rep. 2022 Nov 5;3(1):100135. doi: 10.1016/j.xagr.2022.100135. eCollection 2023 Feb.
There is debate on whether uterine gauze packing or intrauterine balloon tamponade is safer and more effective as a surgical management option for treating postpartum hemorrhage.
This study aimed to compare intra- and postoperative outcomes of intrauterine balloon tamponade and uterine gauze packing in patients with postpartum hemorrhage.
A range of databases such as Cochrane and PubMed were searched using terms including "post-partum haemorrhage," "uterine balloon tamponade," and "uterine gauze packing." All observational studies comparing intrauterine balloon tamponade with uterine gauze packing were included. Five studies were identified enrolling 821 adult patients diagnosed with postpartum hemorrhage. Primary outcomes included blood loss volume, success rates, and maternal mortality. Secondary outcomes comprised requiring additional interventions, postoperative hemoglobin levels, and requiring blood transfusions. Fixed and random models were used for analysis.
Intrauterine balloon tamponade seemed to be a superior option to uterine gauze packing. Intrauterine balloon tamponade was better in reducing intraoperative blood loss, with a statistically significant improvement (<.0001). Cases managed with intrauterine balloon tamponade seemed to have statistically significant shorter operative time (=.023) and hospital length of stay (=.020) in one study.
Intrauterine balloon tamponade remains more effective and safer as a first-line surgical management option for postpartum hemorrhage compared with uterine gauze packing.
对于子宫纱布填塞术或宫腔球囊压迫止血法作为治疗产后出血的手术管理选项,哪一种更安全、更有效,目前存在争议。
本研究旨在比较宫腔球囊压迫止血法和子宫纱布填塞术治疗产后出血患者的术中及术后结果。
使用包括“产后出血”、“宫腔球囊压迫止血法”和“子宫纱布填塞术”等术语检索了一系列数据库,如Cochrane和PubMed。纳入了所有比较宫腔球囊压迫止血法与子宫纱布填塞术的观察性研究。共确定了5项研究,纳入了821例诊断为产后出血的成年患者。主要结局包括失血量、成功率和孕产妇死亡率。次要结局包括是否需要额外干预、术后血红蛋白水平以及是否需要输血。采用固定模型和随机模型进行分析。
宫腔球囊压迫止血法似乎是比子宫纱布填塞术更好的选择。宫腔球囊压迫止血法在减少术中失血量方面效果更好,具有统计学意义的改善(<.0001)。在一项研究中,采用宫腔球囊压迫止血法治疗的病例手术时间(=.023)和住院时间(=.020)在统计学上似乎显著更短。
与子宫纱布填塞术相比,宫腔球囊压迫止血法作为产后出血的一线手术管理选项仍然更有效、更安全。