AbdRabbo S A
Department of Obstetrics and Gynecology, Shatby Maternity University Hospital, Alexandria, Egypt.
Am J Obstet Gynecol. 1994 Sep;171(3):694-700. doi: 10.1016/0002-9378(94)90084-1.
The objective of this study was to test the efficacy of a novel stepwise technique of uterine devascularization for management of uncontrollable postpartum hemorrhage.
Stepwise uterine devascularization was performed for 103 patients to control intractable postpartum hemorrhage not responding to classic management. This technique entails five successive steps, so if bleeding is not controlled by one step the next step is taken until bleeding stops. The steps were (1) unilateral uterine vessel ligation, (2) bilateral uterine vessel ligation, (3) low uterine vessel ligation, (4) unilateral ovarian vessel ligation and (5) bilateral ovarian vessel ligation.
The procedure was effective in all cases (100%), and hysterectomy was not needed in any case. No complications occurred, and the survival rate was 100%. Among the patients followed up normal menstruation and pregnancy occurred.
Stepwise uterine devascularization is an effective and safe alternative to hysterectomy for management of uncontrollable postpartum hemorrhage.
本研究的目的是测试一种新型子宫去血管化分步技术治疗难治性产后出血的疗效。
对103例患者进行分步子宫去血管化，以控制对传统治疗无反应的难治性产后出血。该技术包括五个连续步骤，因此如果一步不能控制出血，则采取下一步，直到出血停止。步骤为：（1）单侧子宫血管结扎，（2）双侧子宫血管结扎，（3）低位子宫血管结扎，（4）单侧卵巢血管结扎和（5）双侧卵巢血管结扎。
该手术在所有病例中均有效（100%），无一例需要子宫切除术。未发生并发症，生存率为100%。在随访的患者中，出现了正常月经和妊娠。
分步子宫去血管化是治疗难治性产后出血的一种有效且安全的子宫切除术替代方法。
