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Uterine isthmic tourniquet left in situ as a new approach for placenta previa-accreta surgery: a comparative study.
Bagli, Ihsan; Öcal, Ece; Bala, Mesut; Tahaoglu, Zelal; Bakir, Mehmet Sait; Halisçelik, Mesut Ali; Bademkiran, Cihan; Gül, Erdogan.
Afiliación
  • Bagli I; Department of Obstetrics and Gynecology, University of Health Sciences Diyarbakir Gazi Yasargil Egitim Arastirma Hastanesi Ek Bina, Urfa Yolu, Baglar, 21090, Diyarbakir, Türkiye.
  • Öcal E; Private Clinic of Perinatology, Diyarbakir, Türkiye.
  • Bala M; Department of Obstetrics and Gynecology, University of Health Sciences Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Türkiye.
  • Tahaoglu Z; Department of Obstetrics and Radiology, University of Health Sciences Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Türkiye.
  • Bakir MS; Department of Gynecologic Onkology, Mersin City Hospital, Mersin, Türkiye.
  • Halisçelik MA; Department of Obstetrics and Gynecology, University of Health Sciences Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Türkiye.
  • Bademkiran C; Department of Obstetrics and Gynecology, University of Health Sciences Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Türkiye.
  • Gül E; Department of Obstetrics and Gynecology, University of Health Sciences Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Türkiye.
J Perinat Med ; 52(8): 863-869, 2024 Oct 28.
Article en En | MEDLINE | ID: mdl-39097938
ABSTRACT

OBJECTIVES:

Placenta previa-accreta spectrum disorders are a cause of obstetric hemorrhage that can lead to maternal fetal mortality and morbidity. We aimed to describe the use of a uterine isthmic tourniquet left in situ as a new uterus-preserving approach for patients with placenta previa-accreta.

METHODS:

In this retrospective comparative study, the patients who underwent surgery for placenta previa between 2017 and 2024 at our tertiary hospital were reviewed. Primary outcome of the study is to evaluate feasibility of uterine isthmic tourniquet left in situ for uterine preserving by preventing postpartum hemorrhage for patients with placenta previa-accreta. As a secondary outcome, group 1 (n=28) patients who were managed with uterine isthmic tourniquet left in place were compared with patients in group 2 (n=32) who were managed with only bilateral uterine artery ligation.

RESULTS:

This new approach uterine isthmic tourniquet technique prevented postpartum hemorrhage with a rate of 100 percent in group 1 patients, while uterine artery ligation prevented postpartum hemorrhage with a rate of 75 % in group 2. Postoperative additional interventions (relaparotomy hysterectomy, balloon tamponade application, uterine or vaginal packing) were performed for eight patients in group 2 (25 %) but not in group 1 (0 %) (p=0.015). The haemoglobin levels before caesarean section were similar in both groups (p=0.235), while the postoperative haemoglobin levels were lower in group 2 (9.69 ± 1.37 vs. 8.15 ± 1.32) (p=0.004). Erythrocyte suspension was given to two patients in group 1 and 12 patients in group 2 (2/28 7 % vs. 12/32 37 %, p=0.018).

CONCLUSIONS:

The uterine isthmic tourniquet left in situ technique is a safe, simple and effective for preventing postpartum hemorrhage and preserving uterus during placenta previa accreta surgery as superior to uterine artery ligation alone.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta Accreta / Placenta Previa / Torniquetes / Hemorragia Posparto Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Perinat Med Año: 2024 Tipo del documento: Article Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta Accreta / Placenta Previa / Torniquetes / Hemorragia Posparto Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Perinat Med Año: 2024 Tipo del documento: Article Pais de publicación: Alemania