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Int J Gynaecol Obstet ; 162(2): 664-668, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36762582

RESUMEN

OBJECTIVES: To evaluate surgical outcomes of using a double uterine segment tourniquet in obstetric hysterectomy for bleeding control in patients with placenta accreta spectrum. METHODS: Retrospective case-control study conducted at the Central Hospital of San Luis Potosi, Mexico. Patients with the diagnosis of placenta accreta spectrum who underwent obstetric hysterectomy were included. Two groups were formed: in the first, a double uterine segment tourniquet was used; and in the second, the hysterectomy was performed without a tourniquet. Primary surgical outcomes were compared. RESULTS: Forty patients in each group were included. The use of a double uterine segment tourniquet had lower total blood loss compared with the non-tourniquet group (1054.00 ± 467.02 vs. 1528.75 ± 347.12 mL, P = 0.0171) and a lower drop in hemoglobin (1.74 ± 1.10 vs. 2.60 ± 1.25 mg/dL, P = 0.0486). Ten patients (23.80%) in the double tourniquet group required blood transfusion, compared with 26 (65.00%) in the non-tourniquet group (P = 0.0003). Surgical time did not show a statistical difference between groups. CONCLUSION: The use of a uterine segment tourniquet in obstetric hysterectomy may improve surgical outcomes in patients with placenta accreta spectrum with no difference in surgical time and urinary tract lesions.


Asunto(s)
Placenta Accreta , Hemorragia Posparto , Embarazo , Femenino , Humanos , Placenta Accreta/cirugía , Placenta Accreta/etiología , Estudios Retrospectivos , Estudios de Casos y Controles , Hemorragia Posparto/cirugía , Hemorragia Posparto/etiología , Cesárea/efectos adversos , Histerectomía/efectos adversos
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