Postpartum hysterectomy: causes of obstetric hemorrhage and improved approach to surgical intervention


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Objective: To improve the technique of postpartum hysterectomy in massive postpartum obstetric hemorrhage using an integrated approach which includes methods of surgical hemostasis and the placement of Zhukovsky vaginal and uterine catheters. Materials and methods: The study included 52 puerperas with massive obstetric hemorrhage who underwent hysterectomy to stop the bleeding. In order to assess the effectiveness of the hysterectomy method, the participants were divided into two groups: group 1 consisted of 23 women who used Zhukovsky vaginal and uterine catheters; group 2 included 29 puerperas who received traditional obstetric care. The effectiveness of treatment was assessed using two criteria: blood loss volume and transfusion volume. Results: There were the following causes of postpartum hemorrhage: placenta accreta - 25/52 (48.1%), uterine atony - 17/52 (32.7%), uteroplacental apoplexy complicating placental abruption - 8/52 (15.4), amniotic fluid embolism - 2/52 (3.8%). The total volume of blood loss was 1.3 times lower in the comparison group. Blood loss in multiparous women was 3500 ml, which was less (p=0.021) than in primiparous and secondiparous women (5000 ml). The use of Zhukovsky vaginal and uterine catheters during hysterectomy made it possible to reduce the volume of total blood loss by 1.3 times (p<0.001), reduce the volume of transfused fresh frozen plasma by 1.4 times (p<0.001), decrease erythrocyte mass by 1.4 times (p<0.001). Conclusion: The use of combined tactics during postpartum hysterectomy can reduce blood loss volume and decrease the risk of postoperative complications.

全文:

受限制的访问

作者简介

Sergey Barinov

Omsk State Medical University

Email: barinov_omsk@mail.ru
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No. 2

Irina Medyannikova

Omsk State Medical University

Email: mediren@gmail.com
Dr. Med. Sci., Associate Professor, Professor at the Department of Obstetrics and Gynecology No. 2

Yulia Tirskaya

Omsk State Medical University

Email: yulia.tirskaya@yandex.ru
Dr. Med. Sci., Associate Professor, Professor at the Department of Obstetrics and Gynecology No. 2

Tatyana Kadtsyna

Omsk State Medical University

Email: tatianavlad@list.ru
PhD, Associate Professor at the Department of Obstetrics and Gynecology No. 2

Evgenia Nadezhina

Perinatal Center, Regional Clinical Hospital

Email: mec86.86@mail.ru
obstetrician-gynecologist at the Obstetric Physiological Department

Oksana Lazareva

Omsk State Medical University

Email: lazow@mail.ru
PhD, Associate Professor at the Department of Obstetrics and Gynecology No. 2

Yulia Kovaleva

Perinatal Center, Regional Clinical Hospital

Email: kovalevajulia7l@yandex.ru
obstetrician-gynecologist, Head of the Obstetric Department of Pregnancy Pathology

Olga Grebenyuk

Perinatal Center, Regional Clinical Hospital

Email: olgaomsk@inbox.ru
PhD, Head of the Obstetric Physiological Department

Irina Razdobedina

Perinatal Center, Regional Clinical Hospital

obstetrician-gynecologist, Head of the Obstetric Observational Department

参考

  1. Курцер М.А., Бреслав И.Ю., Латышкевич О.А., Григорьян А.М. Временная баллонная окклюзия общих подвздошных артерий у пациенток с рубцом на матке после кесарева сечения и placenta accrete, преимущества и возможные осложнения. Акушерство и гинекология. 2016; 12: 70-5
  2. Zhang Y., Yan J., Han Q., Yang T., Cai L., Fu Y. et al. Emergency obstetric hysterectomy for life-threatening postpartum hemorrhage: A 12-year review. Medicine (Baltimore). 2017; 96(45): e8443. https://dx.doi.org/10.1097/ MD.0000000000008443.
  3. Hajmurad O.S., Choxi A.A., Zahid Z., Dudaryk R. Aortoiliac thrombosis following tranexamic acid administration during urgent cesarean hysterectomy: a case report. A Case Rep. 2017; 9(3): 90-3. https://dx.doi.org/10.1213/ XAA.0000000000000535.
  4. Senturk M.B., Cakmak Y., Guraslan H., Dogan K. Emergency peripartum hysterectomy: 2-year experiences in non-tertiary center. Arch. Gynecol. Obstet. 2015; 292(5): 1019-25. https://dx.doi.org/10.1007/s00404-015-3740-z.
  5. Malinowska-Polubiec A., Romejko-Wolniewicz E., Zareba-Szczudlik J., Dobrowolska-Redo A., Sotowska A., Smolarczyk R. et al. Emergency peripartum hysterectomy - a challenge or an obstetrical defeat? Neuro Endocrinol; Lett. 2016; 37(5): 389-94.
  6. Campbell S.M., Corcoran P., Manning E., Greene R.; Irish Maternal Morbidity Advisory Group. Peripartum hysterectomy incidence, risk factors and clinical characteristics in Ireland. Eur. J. Obstet. Gynecol. Reprod. Biol. 2016; 207: 56-61. https://dx.doi.org/10.1016/j.ejogrb.2016.10.008.
  7. Sikora-Szczęśniak D.L., Szczęśniak G., Szatanek M., Sikora W., Sikora-Szczęśniak D. Clinical analysis of 52 obstetric hysterectomies. Ginekol. Pol. 2016; 87(6): 460-6. https://dx.doi.org/10.5603/GP.2016.0026.
  8. Calvo-Aguilar O., Vasquez-Martinez J., Hernandez-Cuevas P. Obstetric hysterectomy in the General Hospital Dr. Aurelio Valdivieso: three-year review. Ginecol. Obstet. Mex. 2016; 84(2): 72-8.
  9. Temizkan O., Angin D., Karaku§ R., §anverdi i., Polat M., Tahaoglu A.E. et al. Changing trends in emergency peripartum hysterectomy in a tertiary obstetric center in Turkey during 2000-2013. J. Turk. Ger. Gynecol. Assoc. 2016; 17(1): 26-34. https://dx.doi.org/10.5152/jtgga.2015.16239.
  10. Chen J., Cui H., Na Q., Li Q., Liu C. Analysis of emergency obstetric hysterectomy: the change of indications and the application of intraoperative interventions. Zhonghua Fu Chan Ke Za Zhi. 2015; 50(3): 177-82.
  11. Pan X.Y., Wang Y.P., Zheng Z., Tian Y., Hu Y.Y., Han S.H. A Marked increase in obstetric hysterectomy for placenta accreta. Chin. Med. J. (Engl.). 2015; 128(16): 2189-93. https://dx.doi.org/10.4103/0366-6999.162508.
  12. Begum M., Alsafi F., ElFarra J., Tamim H.M., Le T. Emergency peripartum hysterectomy in a tertiary care hospital in saudi arabia. J. Obstet. Gynaecol. India. 2014; 64(5): 321-7. https://dx.doi.org/10.1007/s13224-013-0423-1.
  13. Matsuzaki S., Yoshino K., Kumasawa K., Satou N., Mimura K., Kanagawa T. et al. Placenta percreta managed by transverse uterine fundal incision with retrograde cesarean hysterectomy: a novel surgical approach. Clin. Case Rep. 2014; 2(6): 260-4. https://dx.doi.org/10.1002/ccr3.108.
  14. Виницкий А.А., Шмаков Р.Г. Современные представления об этиопато-генезе врастания плаценты и перспективы его прогнозирования молекулярными методами диагностики. Акушерство и гинекология. 2017; 2: 5-10. [Vinitsky A.A., Shmakov R.G. Modern ideas about the etiopathogenesis of placenta ingrowth and the prospects for its prediction by molecular diagnostic methods. Obstetrics and Gynecology. 2017; 2: 5-10 (in Russian)]. https://dx.doi.org/10.18565/aig.2017.25-10.
  15. Huls C.K. Cesarean hysterectomy and uterine-preserving alternatives. Obstet. Gynecol. Clin. North. Am. 2016; 43(3): 517-38. https://dx.doi.org/10.1016/j.ogc.2016.04.010.
  16. Fawad A., Islam A., Naz H., Nelofar T., Abbasi U.N. Emergency peri partum hysterectomy-a life saving procedure. J. Ayub. Med. Coll. Abbottabad. 2015; 27(1): 143-5.
  17. Palacios-Jaraquemada J.M. Caesarean section in cases of placenta praevia and accreta. Best Pract. Res. Clin. Obstet. Gynaecol. 2013; 27(2): 221-32. https://dx.doi.org/10.1016/j.bpobgyn.2012.10.003.
  18. Friedman A.M., Wright J.D., Ananth C.V., Siddiq Z., D'Alton M.E., Bateman B.T. Population-based risk for peripartum hysterectomy during low- and moderate-risk delivery hospitalizations. Am. J. Obstet. Gynecol. 2016; 215(5): 640.e1-640. e8. https://dx.doi.org/10.1016/j.ajog.2016.06.032.
  19. Jakobsson M., Tapper A.M., Colmorn L.B., Lindqvist P.G., Klungs0yr K., Krebs L. et al.; NOSS Study Group. Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS). Acta Obstet. Gynecol. Scand. 2015; 94(7): 745-54. https://dx.doi.org/10.1111/aogs.12644.
  20. Gillespie C., Sangi-Haghpeykar H., Munnur U., Suresh M.S., Miller H., Hawkins S.M. The effectiveness of a multidisciplinary, team-based approach to cesarean hysterectomy in modern obstetric practice. Int. J. Gynaecol. Obstet. 2017; 137(1): 57-62. https://dx.doi.org/10.1002/ijgo.12093.
  21. Tahaoglu A.E., Balsak D., Togrul C., Obut M., Tosun O., Cavus Y. et al. Emergency peripartum hysterectomy: our experience. Ir. J. Med. Sci. 2016; 185(4): 833-8. https://dx.doi.org/10.1007/s11845-015-1376-4.
  22. De la Cruz C.Z., Thompson E.L., O'Rourke K., Nembhard W.N. Cesarean section and the risk of emergency peripartum hysterectomy in high-income countries: a systematic review. Arch. Gynecol. Obstet. 2015; 292(6): 1201-15. https://dx.doi.org/10.1007/s00404-015-3790-2.
  23. Пенжоян Г. А., Макухина Т.Б., Мингалева Н.В., Солнцева А.В., Амирханян А.М. Менеджмент пациенток с врастанием плаценты на разных сроках гестации. Акушерство и гинекология: новости, мнения, обучение. 2019; 7(1): 79-84. [Penzhoyan G.A., Makukhina T.B., Mingaleva N.V., Solntseva A.V., Amirkhanyan A.M. Management of patients with placenta accreta at different gestational ages. Obstetrics and Gynecology: News, Opinions, Training. 2019; 7(1): 79-84 (in Russian)]. https://dx.doi.org/10.24411/2303-9698-2019-11011.
  24. Забелина Т.М., Васильченко О.Н., Каримова Г.Н., Ежова Л.С., Учеваткина П.В., Шмаков Р.Г. Родоразрешение беременных с врастанием плаценты без рубца на матке. Акушерство и гинекология. 2021; 4: 150-6. [Zabelina T.M., Vasilchenko O.N., Karimova G.N., Ezhova L.S., Uchevatkina P.V., Shmakov R.G. Delivery ofpregnant women with placenta increta and no uterine scar. Obstetrics and Gynecology. 2021; 4: 150-6. (in Russian)]. https://dx.doi.org/10.18565/aig.2021.4.150-156.
  25. Soleymani Majd H., Collins S.L., Addley S., Weeks Е., Chakravarti S., Haider S. et al. The modified radical peripartum cesarean hysterectomy (Soleymani-Alazzam-Collins technique): a systematic, safe procedure for the management of severe placenta accreta spectrum. Am. J. Obstet. Gynecol. 2021; 225(2): 175. e1-175.e10. https://dx.doi.org/10.1016/j.ajog.2021.03.014.
  26. Palacios-Jaraquemada J.M., Fiorillo A., Hamer J., Martinez M., Bruno C. Placenta accreta spectrum: a hysterectomy can be prevented in almost 80% of cases using a resective-reconstructive technique. J. Matern. Fetal Neonatal Med. 2022; 35(2): 275-82. https://dx.doi.org/10.1080/14767058.2020.1716715.
  27. Colmorn L.B., Krebs L., Langhoff-Roos J.; NOSS Study Group. Potentially avoidable peripartum hysterectomies in Denmark: A population based clinical audit. PLoS One. 2016; 11(8): e0161302. https://dx.doi.org/10.1371/journal.pone.0161302.
  28. Lo A., Yadav P., Belisle E., Markenson G. The impact of Bakri balloon tamponade on the rate of postpartum hysterectomy for uterine atony. J. Matern. Fetal Neonatal Med. 2017; 30(10): 1163-6. https://dx.doi.org/10.1080/14767058.2016.1208742.
  29. Barinov S., Tirskaya Y., Medyannikova I., Shamina I., Shavkun I. A new approach to fertility-preserving surgery in patients with placenta accreta. J. Matern. Fetal Neonatal Med. 2019; 32(9): 1449-53. https://dx.doi.org/10.1080/14767058.2017.1408066.
  30. Dogan O., Pulatoglu C., Yassa M. A new facilitating technique for postpartum hysterectomy at full dilatation: Cervical clamp. J. Chin. Med. Assoc. 2018; 81(4): 366-9. https://dx.doi.org/10.1016/j.jcma.2017.05.010.

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Bionika Media, 2022
##common.cookie##