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Alternate Sequential Suture Tightening: A Novel Technique for Uncontrolled Postpartum Hemorrhage

机译:交替顺序缝合拧紧:一种不受控制的产后出血的新技术

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摘要

Objective. The most commonly described technique of modified B-Lynch suture may not be suitable for all the patients presenting with flabby, atonic uterus. Study Design. A retrospective analysis of twelve patients with uncontrolled postpartum haemorrhage, who underwent this procedure from March 2007 to September 2012, was conducted. In this novel technique, sutures are passed in the lower uterine segment and are tightened alternately to control uterine bleeding. Results. Average duration of the procedure was 4 minutes (range 2–7 minutes). Average blood loss was 1625 mL (range 1300–1900 mL). Eleven patients (91.66%) were seen to have a successful outcome with only this technique. No patient required hysterectomy and one patient (8.33%) required additional bilateral internal iliac artery ligation. All the patients had a minimum follow-up of 2 yrs and none of them reported any infertility problems. Conclusion. This technique is simple, quick, and effective. There was no adverse effect on the fertility potential for the observed 2 years; however, a long-term follow-up is required to comment on its actual rate. This technique cannot replace the standard modified B-Lynch technique for uncontrolled postpartum haemorrhage but can be used for unresponsive, flabby, and atonic uterus.
机译:目的。最常用的改良B-Lynch缝合技术可能不适用于所有患有松弛,无瓣膜子宫的患者。学习规划。回顾性分析了从2007年3月至2012年9月接受此手术的12例产后出血不受控制的患者。在这种新技术中,缝线在子宫下段通过并交替拧紧以控制子宫出血。结果。该过程的平均持续时间为4分钟(范围为2-7分钟)。平均失血量为1625 mL(范围1300-1900 mL)。仅使用此技术,就有11名患者(91.66%)取得了成功的结局。没有患者需要子宫切除术,一名患者(8.33%)需要额外的双侧internal内动脉结扎。所有患者的最低随访时间为2年,均未报告任何不育问题。结论。此技术简单,快速且有效。在观察到的2年中对生育能力没有不利影响;但是,需要进行长期随访以评论其实际汇率。该技术不能代替标准的改良B-Lynch技术治疗无法控制的产后出血,但可以用于反应迟钝,松弛和无力的子宫。

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