Abstract | AIM: MATERIALS AND METHODS: The study included 54 patients with MAP. All patients underwent cesarean section with application of surgical hemostasis techniques. In Group 1 (n = 15), ligation of IIA was performed, in Group 2 (n = 18) extravasal temporary occlusion of CIA, and in Group 3 (n = 21) combined compression hemostasis was applied. The latter technique included placement of bilateral tourniquets on the upper uterine pedicles and on the cervicoisthmic segment, and controlled Zhukovsky balloon tamponade of the uterus, with subsequent resection of the uterine wall with abnormal placental invasion, evacuation of placenta from the uterine cavity and closure of the uterine wall defect with a double suture. The studied outcomes were total blood loss, duration of surgery, the hemoglobin level alteration, hysterectomy rate, and length of postoperative hospital stay. RESULTS: Total blood loss in Group 1 was 2440 ± 1215 ml, in Group 2 - 2186 ± 1353 ml, and in Group 3 - 1295 ± 520.3 ml (p = .0045). In Group 3, the lowest number of cases with blood loss >2000 ml was observed [8 (53.3%) versus 9 (50.0%) and 2 (9.5%), respectively; p = .0411]. The duration of surgery, the hemoglobin level alteration, hysterectomy rate, and length of hospital stay after delivery did not differ significantly between the groups. CONCLUSIONS: All surgical techniques used in the study were effective to decrease the blood loss during cesarean section in patients with MAP; however, the combined compression hemostasis showed the highest efficacy.
|
Authors | Roman G Shmakov, Aleksandr A Vinitskiy, Vladimir D Chuprinin, Ekaterina L Yarotskaya, Gennady T Sukhikh |
Journal | The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
(J Matern Fetal Neonatal Med)
Vol. 32
Issue 12
Pg. 2042-2048
(Jun 2019)
ISSN: 1476-4954 [Electronic] England |
PMID | 29402157
(Publication Type: Comparative Study, Controlled Clinical Trial, Journal Article)
|
Topics |
- Adult
- Cesarean Section
- Female
- Hemostasis, Surgical
(methods)
- Humans
- Organ Sparing Treatments
- Placenta Diseases
(surgery)
- Pregnancy
|