Conservative surgical management for immediate postpartum hemorrhage
oraz | 30 gru 2019
O artykule
Article Category: Brief communication (original)
Data publikacji: 30 gru 2019
Zakres stron: 107 - 111
DOI: https://doi.org/10.1515/abm-2019-0048
Słowa kluczowe
© 2019 Puangsricharoen and Manchana, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Demographic data
| Patient Characteristics | Number of patients | Percent |
|---|---|---|
| Primigravida | 13 | 41.9 |
| Multigravida | 18 | 58.1 |
| Gestational age | ||
| 28–36 weeks | 10 | 32.3 |
| 37–42 weeks | 21 | 67.7 |
| Route of delivery | ||
| Vaginal delivery | 3 | 9.7 |
| Elective cesarean delivery | 9 | 29 |
| Emergency cesarean delivery | 19 | 61.3 |
| Indication for cesarean delivery | ||
| Cephalopelvic disproportion | 9 | 32.1 |
| Placenta previa | 9 | 32.1 |
| Previous cesarean delivery | 3 | 14.3 |
| Multiple pregnancy | 2 | 10.7 |
| Breech presentation | 4 | 7.1 |
| Cervical mass | 1 | 3.6 |
| Birth weight (g) | ||
| <2,500 | 8 | 25.8 |
| 2,500–3,500 | 18 | 58.1 |
| 3,501–4,000 | 3 | 9.7 |
| >4,000 | 2 | 6.4 |
| Cause of postpartum hemorrhage | ||
| Uterine atony | 23 | 74.2 |
| Placenta previa | 2 | 6.5 |
| Bleeding from placental bed | 6 | 19.4 |
| Type of conservative surgical | ||
| management | ||
| Bakri balloon tamponade | 15 | 48.4 |
| B-Lynch uterine compression suture | 13 | 41.9 |
| Uterine artery ligation | 3 | 9.7 |
Outcomes of conservative surgical treatments
| Bakri balloon tamponade | B-Lynch uterine compression suture | Uterine artery ligation | |
|---|---|---|---|
| ( | ( | ( | |
| Estimated blood loss, ml (mean ± SD) | 3,346 ± 2,647 ml | 2,984 ± 2,540 ml | 2,133 ± 1,001 ml |
| Blood component, units (mean ± SD) | |||
| Packed red cells | 8 ± 5 | 8 ± 3 | 2 ± 3 |
| Fresh frozen plasma | 7 ± 3 | 5 ± 3 | 1 ± 4 |
| Platelets | 5 ± 5 | 2 ± 5 | 0 |
| Perioperative complications | |||
| Disseminated intravascular coagulopathy | 5 (33.3%) | 3 (23.1%) | 0 |
| Bladder injury | 1 (6.7%) | 1 (7.7%) | 0 |
| Bowel injury | 1 (6.7%) | 1 (7.7%) | 0 |
| Hospital stay (days) (mean ± SD) | 15 ± 7 | 13 ± 5.9 | 3 ± 10 |
| Failure rate (conversion to hysterectomy) | 4 (26.7%) | 3 (23.1%) | 1 (33.3%) |
| Subsequent pregnancy in patients who desired | 25% (1/4) | 20% (1/5) | 50% (1/2) |