1
|
An J. Subsequent pregnancy in women who have undergone bilateral uterine artery ligation during cesarean section: A case series. Exp Ther Med 2024; 27:9. [PMID: 38223319 PMCID: PMC10785031 DOI: 10.3892/etm.2023.12296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/20/2023] [Indexed: 01/16/2024] Open
Abstract
Bilateral uterine artery ligation (BUAL) serves as an effective surgical devascularization procedure in obstetric emergencies. However, concerns regarding the impact of uterine devascularization have evoked dispute. Here, the fetal growth index and obstetrical outcomes during the subsequent pregnancy of women who had undergone BUAL during cesarean section are reported. The case series of women who underwent BUAL during cesarean section and had another delivery later at the Xiamen Women and Children's Hospital between 2011 and 2020 is described. Pregnancies that did not continue beyond 20 weeks of gestation were excluded. Cases were identified from neonatal and obstetric databases and the clinical data of all cases were extracted. A total of 12 cases were identified retrospectively. Fetal biometric parameters of subsequent pregnancies in all cases including biparietal diameter, head circumference, abdominal circumference, and femur length are presented graphically across the different gestational ages and were all within the range of the 3rd-97th percentile. No maternal or neonatal morbidity was observed. BUAL did not appear to compromise a woman's subsequent obstetric outcomes. As a safe and simple surgical technique, it is safe to recommend BUAL in clinical practice.
Collapse
Affiliation(s)
- Jian An
- Department of Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian 361000, P.R. China
| |
Collapse
|
2
|
Zouaghi C, Chaouch MA, Sanchez S, Zouaghi S. Hysteroscopy after conservative surgical treatment of severe postpartum hemorrhage due to uterine atony: A systematic literature review. Int J Gynaecol Obstet 2023. [PMID: 36710527 DOI: 10.1002/ijgo.14704] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To assess the prevalence of intrauterine anomalies, primarily intrauterine adhesions (IUAd), after conservative surgical treatment of severe postpartum hemorrhage with uterine atony (SPPH-UA) and determine patient eligibility for hysteroscopy. METHODS PubMed and the Cochrane Library were searched by combining keywords "postpartum hemorrhage", "uterine atony", and "hysteroscopy" to perform a literature review. Articles in French and English with more than five cases of hysteroscopy following SPPH-UA were selected. All cases that had hysteroscopy after conservative surgical treatment of SPPH-UA were collected. A blinded statistical analysis revealed IUAd risk factors. RESULTS In all, 83% of patients agreed to hysteroscopy and 38% of 71 cases had an IUAd. Age was not a risk factor (P = 0.950). Other factors included multiparity (odds ratio [OR] 1.93, P = 0.039), cesarean delivery (OR 3.58, P = 0.584) and postpartum infection (OR 3.33, P = 0.04). Risk was at 57% after uterine padding with multiple transfixing square stitches (Cho-technique) (P = 0.001), 6% after non-transfixing uterine folding brace suture (B-Lynch technique) when used alone, 29% after uterine artery embolization and after internal iliac artery ligation (OR 0.98, P = 0.645); uterine vascular ligation (OR 0.69, P = 0.253) and more than two procedures (OR 0.69, P = 2.53). Disparity between authors was observed (P = 0.015) and concerned only the surgical techniques used. CONCLUSION A classification is proposed for deciding post-SPPH hysteroscopy. Further studies are required to determine appropriateness.
Collapse
Affiliation(s)
- Chiheb Zouaghi
- Department of Gynecology and Obstetrics, Nevers Agglomeration Hospital, Nevers, France
| | - Mohamed Ali Chaouch
- Department of Visceral Surgery, Monastir University Hospital, Monastir, Tunisia
| | - Stephane Sanchez
- Public Health and Performance Department, Champagne Sud Hospital, Troyes, France
| | | |
Collapse
|
3
|
Lemée J, Scalabre A, Chauleur C, Raia-Barjat T. Visual estimation of postpartum blood loss during a simulation training: A prospective study. J Gynecol Obstet Hum Reprod 2019; 49:101673. [PMID: 31816433 DOI: 10.1016/j.jogoh.2019.101673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/26/2019] [Accepted: 11/29/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of our study was to compare visually estimated blood loss (with collector bags and absorbent pads) during postpartum with the real volume during a simulation training. STUDY DESIGN This study was conducted from May 23 to December 22, 2017 during training sessions on the theme of postpartum haemorrhage provided by the Elena perinatal network. 137 participants visually estimated the losses contained in 5 graduated collector bags (from 600 to 1800mL) and on 5 absorbent pads (from 200 to 1000mL). RESULTS The averages of the visual estimated blood loss were significantly different from the real value, except for absorbent pads containing 400mL of losses. The low volumes are better estimated for either the absorbent pads or collector bags (p<0.001). 57% of the volumes were underestimated with collector bags, 33% of the estimates were accurate to ± 50 mL. With absorbent pads, 51% of the estimates were underestimated, compared to 22%, that were accurate. CONCLUSION The simulation training allows to test the capacities of visual estimation of blood loss by health professionals in order to improve them and to improve the maternal care during postpartum haemorrhage.
Collapse
Affiliation(s)
- Juliette Lemée
- Department of Gynaecology and Obstetrics, University Hospital, Saint Etienne, France
| | - Aurélien Scalabre
- Department of Pediatric Surgery, University Hospital, Saint-Etienne, France
| | - Céline Chauleur
- Department of Gynaecology and Obstetrics, University Hospital, Saint Etienne, France; Department of Pediatric Surgery, University Hospital, Saint-Etienne, France
| | - Tiphaine Raia-Barjat
- Department of Gynaecology and Obstetrics, University Hospital, Saint Etienne, France; Department of Pediatric Surgery, University Hospital, Saint-Etienne, France.
| |
Collapse
|
4
|
Imafuku H, Yamada H, Morizane M, Tanimura K. Recurrence of post-partum hemorrhage in women with a history of uterine artery embolization. J Obstet Gynaecol Res 2019; 46:119-123. [PMID: 31608524 DOI: 10.1111/jog.14129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/06/2019] [Indexed: 11/29/2022]
Abstract
AIM To evaluate pregnancy outcome and complications in subsequent pregnancies after severe post-partum hemorrhage (PPH) between women with and without a history of uterine artery embolization (UAE). METHODS Women who had a history of severe PPH, and delivered newborns at ≥22 gestational weeks in subsequent pregnancies were enrolled. Severe PPH was defined as blood loss volume of more than 2000 mL. RESULTS The blood loss volume (median 1581 mL) in women with UAE (n = 14) was significantly more than that in women without UAE (median 1021 mL, n = 32, P < 0.01), and the recurrence rate of severe PPH in women with UAE (n = 5, 35.7%) was significantly higher than that in women without UAE (n = 3, 9.4%, P < 0.05). There were no significant differences in frequencies of premature delivery, hypertensive disorders of pregnancy, fetal growth restriction, or placenta previa/low lying placenta. Of 14 women with UAE, 7 (50.0%) had abnormally invasive placenta, whereas of 32 women without UAE, none had abnormally invasive placenta. CONCLUSION Subsequent pregnancies after UAE for severe PPH had high risks for recurrence of severe PPH.
Collapse
Affiliation(s)
- Hitomi Imafuku
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideto Yamada
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mayumi Morizane
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenji Tanimura
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
5
|
[Obstetric outcomes after uterine compression suture for treatment of postpartum hemorrhage: Long-term monitoring of 40 cases]. ACTA ACUST UNITED AC 2015; 43:509-14. [PMID: 26144065 DOI: 10.1016/j.gyobfe.2015.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 06/03/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Uterine atony is the first cause of postpartum hemorrhage. In caesarean section, different techniques of uterine compression suture exist when uterotonic drugs fail. Their effectiveness is shown but little data on their effects on subsequent pregnancies are available. The aim of this work is analyze of the obstetrical long-term consequences after uterine compression suture. PATIENTS AND METHODS This is a retrospective study of 40 cases of uterine compression suture performed in a level III maternity, between 2004 and 2010. The main objective is the evaluation of the obstetrical prognosis of subsequent pregnancies. The efficacy and safety of surgical techniques, according to their transfixing character or not, were analyzed. RESULTS Eleven pregnancies after uterine compression suture were reported among 14 women whishing another pregnancy. The median time to be pregnant was 27 months (6-78 months). Nine pregnancies were conducted at term. One case of intrauterine growth restriction and a moderate prematurity at 32 weeks were observed. There was no significant difference in efficacy and early surgical complications according to the surgical technique; however, both infectious and ischemic complications were observed after transfixing compression suture. CONCLUSION The obstetric prognosis after a uterine compression suture is kept. The transfixing techniques may cause more infectious and ischemic complications. An evaluation of surgical techniques depending on their transfixing, or not, character on a large cohort is necessary for the evaluation of the influence of the technique on fertility and postoperative complications.
Collapse
|
6
|
Conforti A, Mollo A, Alviggi C, Tsimpanakos I, Strina I, Magos A, De Placido G. Techniques to reduce blood loss during open myomectomy: a qualitative review of literature. Eur J Obstet Gynecol Reprod Biol 2015; 192:90-5. [PMID: 26189110 DOI: 10.1016/j.ejogrb.2015.05.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 05/20/2015] [Accepted: 05/23/2015] [Indexed: 12/01/2022]
Abstract
Open myomectomy is the most adopted surgical strategy in the conservative treatment of uterine fibroids. According to several studies, the likelihood that a woman could develop uterine myomas is estimated around 75% by the age of 50. Open myomectomy is nonetheless a complicated surgery in terms of blood loss and need for transfusion. Many strategies have been published with the aim of limiting intra and post-operative bleeding complications. The scope of this review is to describe in detail the different techniques reported in literature focusing on their validity and safety.
Collapse
Affiliation(s)
- Alessandro Conforti
- University Department of Neuroscience, Reproductive Medicine, Odontostomatology - University of Naples "Federico II", Naples, Italy.
| | - Antonio Mollo
- University Department of Neuroscience, Reproductive Medicine, Odontostomatology - University of Naples "Federico II", Naples, Italy
| | - Carlo Alviggi
- University Department of Neuroscience, Reproductive Medicine, Odontostomatology - University of Naples "Federico II", Naples, Italy
| | - Ioannis Tsimpanakos
- University Department of Obstetrics and Gynaecology, Royal Free Hospital, London NW3 2QG, United Kingdom
| | - Ida Strina
- University Department of Neuroscience, Reproductive Medicine, Odontostomatology - University of Naples "Federico II", Naples, Italy
| | - Adam Magos
- University Department of Obstetrics and Gynaecology, Royal Free Hospital, London NW3 2QG, United Kingdom
| | - Giuseppe De Placido
- University Department of Neuroscience, Reproductive Medicine, Odontostomatology - University of Naples "Federico II", Naples, Italy
| |
Collapse
|
7
|
Haumonté JB, Sentilhes L, Macé P, Cravello L, Boubli L, d’Ercole C. Prise en charge chirurgicale d’une hémorragie du post-partum. ACTA ACUST UNITED AC 2014; 43:1083-103. [DOI: 10.1016/j.jgyn.2014.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
8
|
Later reproductive health after B-Lynch sutures: a follow-up study after 10 years' clinical use of the B-Lynch suture. Fertil Steril 2014; 101:1194-9. [DOI: 10.1016/j.fertnstert.2014.01.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/23/2013] [Accepted: 01/10/2014] [Indexed: 11/18/2022]
|
9
|
Doumouchtsis SK, Nikolopoulos K, Talaulikar VS, Krishna A, Arulkumaran S. Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review. BJOG 2013; 121:382-8. [DOI: 10.1111/1471-0528.12546] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2013] [Indexed: 11/29/2022]
Affiliation(s)
- SK Doumouchtsis
- Department of Obstetrics and Gynaecology; St George's Healthcare NHS Trust; Tooting London UK
| | - K Nikolopoulos
- Department of Obstetrics and Gynaecology; St George's Healthcare NHS Trust; Tooting London UK
| | - VS Talaulikar
- Department of Obstetrics and Gynaecology; St George's Healthcare NHS Trust; Tooting London UK
| | - A Krishna
- Department of Obstetrics and Gynaecology; St George's Healthcare NHS Trust; Tooting London UK
| | - S Arulkumaran
- Department of Obstetrics and Gynaecology; St George's Healthcare NHS Trust; Tooting London UK
| |
Collapse
|
10
|
Rasheed SM, Amin MM, Abd Ellah AH, Abo Elhassan AM, El Zahry MA, Wahab HA. Reproductive performance after conservative surgical treatment of postpartum hemorrhage. Int J Gynaecol Obstet 2013; 124:248-52. [DOI: 10.1016/j.ijgo.2013.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/19/2013] [Accepted: 11/19/2013] [Indexed: 10/26/2022]
|
11
|
Gizzo S, Saccardi C, Patrelli TS, Di Gangi S, Breda E, Fagherazzi S, Noventa M, D'Antona D, Nardelli GB. Fertility rate and subsequent pregnancy outcomes after conservative surgical techniques in postpartum hemorrhage: 15 years of literature. Fertil Steril 2013; 99:2097-107. [PMID: 23498891 DOI: 10.1016/j.fertnstert.2013.02.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 02/08/2013] [Accepted: 02/08/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the most appropriate surgical technique for optimizing hemostasis and preservation of subsequent fertility after postpartum hemorrhage (PPH). DESIGN Systematic review of the literature. SETTING Not applicable. PATIENT(S) None. INTERVENTION(S) Review of MEDLINE, EMBASE, ScienceDirect, and the Cochrane Library. MAIN OUTCOME MEASURE(S) Comparison of the effectiveness of conservative surgical techniques, separately or together, with respect to success rate (ability to stop bleeding and preserve the uterus), fertility rate (subsequent pregnancies or the return of regular menstrual cycles), complication rate of the procedure, and the outcomes of subsequent pregnancies in terms of type of delivery and eventual delivery complications. RESULT(S) Compressive sutures and vessel embolization may be considered life-saving procedures by achieving the best hemostatic efficacy. Data on restoration of menses and pregnancy rates after these procedures are limited by short-term follow-up and by the paucity of studies, especially for vascular ligation. CONCLUSION(S) Pelvic vessel embolization and compressive sutures are associated with high rates of restoration of regular menses and successive pregnancies, even if the former is burdened by an increased rate of placental disorders and fetal growth restriction and the latter by an increased risk of cesarean deliveries and PPH recurrence. Randomized trials would be desirable to define the best management of PPH.
Collapse
Affiliation(s)
- Salvatore Gizzo
- Department of Woman and Child Health, University of Padua, Padua, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Malartic C, Cagnat J, Morel O, Ricbourg A, Gayat É, Mebazaa A, Ledref O, Barranger E. Prise en charge invasive conservatrice pour hémorragie du post-partum : fertilité et devenir obstétrical. ACTA ACUST UNITED AC 2012; 40:582-90. [DOI: 10.1016/j.gyobfe.2012.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 03/28/2012] [Indexed: 11/29/2022]
|
13
|
Uterine-sparing surgical management of postpartum hemorrhage: is it always effective? Arch Gynecol Obstet 2011; 285:925-30. [DOI: 10.1007/s00404-011-2083-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 09/05/2011] [Indexed: 11/25/2022]
|
14
|
Does uterine artery ligation, performed because of a severe postpartum hemorrhage, alter fertility? Fertil Steril 2011; 95:e76; author reply e77. [PMID: 21561610 DOI: 10.1016/j.fertnstert.2011.04.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2011] [Accepted: 04/26/2011] [Indexed: 11/23/2022]
|
15
|
Carcopino X, Blanc J, Courbiere B, Desbriere R, Bretelle F, Boubli L, d’Ercole C. Reply of the authors. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.04.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|