Staniczek Jakub, Manasar-Dyrbuś Maisa, Winkowska Ewa, Skowronek Kaja, Stojko Rafał
Chair and Department of Gynecology, Obstetrics and Gynecological Oncology, Medical University of Silesia, 40-211 Katowice, Poland.
Life (Basel). 2023 Aug 19;13(8):1774. doi: 10.3390/life13081774.
Placenta accreta spectrum (PAS) is a clinical entity significantly increasing the risk of a peripartum hemorrhage. Various surgical methods have been described in the literature, which aim to reduce the risk of bleeding, although they often lack reproducibility and have been performed on low numbers of patients. The aim of this study was to evaluate the use of the Foley catheter as a cervical tourniquet during cesarean sections, in patients with PAS.
All patients who underwent peripartum hysterectomy due to PAS in a large single-center registry were included in the present analysis. The general demographics and clinical characteristics of all participants, including blood loss, and maternal and fetal outcomes, were collected and analyzed.
Twelve participants were included. The mean blood loss was 1200 ± 760 ml during operation and the mean ± SD procedural duration was 89 ± 17 min. The median (Q1-Q3) length of hospital stay post-procedurally was 5 (4-6) days. None of the patients required subsequent urgent surgical procedures after hysterectomy. The median (Q1-Q3) packed red blood cell units transfused in our cohort was 2 (0-3).
Using the Foley catheter as a tourniquet might be an effective method of excessive bleeding prevention in patients with PAS during peripartum hysterectomy.
胎盘植入谱系疾病（PAS）是一种显著增加围产期出血风险的临床病症。文献中描述了各种手术方法，旨在降低出血风险，尽管这些方法往往缺乏可重复性，且实施的患者数量较少。本研究的目的是评估在剖宫产术中，对患有PAS的患者使用Foley导管作为宫颈止血带的效果。
本分析纳入了在一个大型单中心登记处因PAS接受围产期子宫切除术的所有患者。收集并分析了所有参与者的一般人口统计学和临床特征，包括失血量以及母婴结局。
纳入了12名参与者。术中平均失血量为1200±760毫升，平均手术时长为89±17分钟。术后住院时间的中位数（四分位间距）为5（4 - 6）天。子宫切除术后，没有患者需要后续紧急手术。我们队列中输注的红细胞悬液单位的中位数（四分位间距）为2（0 - 3）。
在围产期子宫切除术中，将Foley导管用作止血带可能是预防PAS患者大出血的有效方法。
