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Birge Ö, Kayar İ, Çetin F. The impact of internal iliac artery ligation on hormonal and functional ovarian reserve parameters: A case-control study in patients with postpartum hemorrhage in sub-Saharan Africa. Int J Gynaecol Obstet 2024. [PMID: 38650391 DOI: 10.1002/ijgo.15551] [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: 09/07/2023] [Revised: 01/15/2024] [Accepted: 04/06/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE The study aims to evaluate the long-term impact of internal iliac artery ligation (IIAL) on ovarian hormonal and functional changes in women. The procedure is often used for postpartum hemorrhage and is considered uterus-sparing. However, its effects on ovarian reserve and fertility preservation remain controversial. METHODS This is a retrospective, case-control study involving consecutive female patients aged 17-47 years. These patients underwent successful bilateral IIAL due to severe postpartum hemorrhage between January 2022 and December 2022. The control group included women of matching age, parity, and body mass index (BMI) who did not undergo IIAL. Both groups were followed for 6 months to measure follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, antral follicle counts, and ovarian volume. RESULTS The study comprised 62 patients in the IIAL group and 86 in the control group. No significant differences were found in FSH and LH levels between the two groups (P > 0.05). However, the numbers of antral follicles in both the right and left ovaries were significantly lower in the IIAL group than in the control group (P < 0.05). Ovarian volume did not show a significant difference between the groups (P > 0.05). CONCLUSION The findings suggest that IIAL leads to a significant decrease in the number of ovarian follicles at 6 months post-operation. However, it does not significantly impact FSH and LH levels or ovarian volume.
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Affiliation(s)
- Özer Birge
- Department of Gynecological Oncology, Niger Turkish Friendship Hospital, Niamey, Niger
| | - İlkan Kayar
- Department of Gynecology and Obstetrics, Osmaniye State Hospital, Osmaniye, Turkey
| | - Ferhat Çetin
- Department of Gynecology and Obstetrics, Osmaniye Park Hospital, Osmaniye, Turkey
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Denizli R, Farısoğulları N, Sakcak B, Özkavak OO, Kara Ö, Tanaçan A, Şahin D. Comparison of H-Hayman uterine compression suture with conventional vertical sutures: A cross-sectional study in a tertiary center. Int J Gynaecol Obstet 2023; 163:123-130. [PMID: 37415278 DOI: 10.1002/ijgo.14985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE To compare H-Hayman, a modified uterine compression suturing technique (UCS) that we describe for the first time in the literature, with conventional vertical UCS techniques. METHODS The H-Hayman technique was used in 14 women and the conventional UCS technique in 21 women. In order to provide standardization in the study, only patients who had developed upper-segment atony during cesarean section were recruited for the study. RESULTS Bleeding control was achieved in 85.7% (12/14) of the cases using the H-Hayman technique. In the remaining two patients with persistent hemorrhage in this group, bleeding control was provided with bilateral uterine artery ligation, and a hysterectomy was avoided in all cases. With the conventional technique, bleeding control was achieved in 76.1% (16/21) of the patients, and the overall success rate was 95.2% after bilateral uterine artery ligation in those with persistent hemorrhage. In addition, the estimated blood loss and the need for erythrocyte suspension transfusion were significantly lower in the H-Hayman group (P = 0.01 and P = 0.04, respectively). CONCLUSION We found the H-Hayman technique to be at least as successful as conventional UCS. In addition, patients who underwent suturing with the H-Hayman technique had less blood loss and a lower requirement for erythrocyte suspension transfusion.
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Affiliation(s)
- Ramazan Denizli
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Nihat Farısoğulları
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedri Sakcak
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Osman Onur Özkavak
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Zhang X, Cao H, Wang H, Li X, Chen L, Shi Q, Li J. Curative effect of cervical lifting suture combined with the improved Hayman suture in pernicious placenta previa under noninterventional conditions: A retrospective cohort study. Int J Gynaecol Obstet 2023. [PMID: 36637227 DOI: 10.1002/ijgo.14667] [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: 04/21/2022] [Revised: 12/13/2022] [Accepted: 01/04/2023] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To propose a novel operative strategy involving cervical lifting suture (CLS) in conjunction with the improved Hayman suture (CLS-Hayman) to apply in the cesarean section of pernicious placenta previa (PPP) under noninterventional conditions and evaluate the curative effect of the CLS-Hayman operation by comparing with conventional CLS. METHODS A retrospective cohort study was conducted on 119 pregnant women diagnosed with PPP, including 50 cases in the CLS-Hayman group and 69 cases in the CLS group. The authors used different statistical methods to compare intraoperative bleeding, 24-h postpartum bleeding, postoperative complication rates, and uterine involution between the two groups under noninterventional conditions. RESULTS The median intraoperative blood loss was 800 mL in the CLS-Hayman group versus 1000 mL in the CLS group. The amount of 24-h postpartum bleeding in the CLS-Hayman group was lower than that in the CLS group. The complication rates in the two groups were 12% and 27.5%, respectively (P = 0.04). B-ultrasound or magnetic resonance imaging data showed that the uterine involution was better in the CLS-Hayman group. CONCLUSION The CLS-Hayman suture achieves the desired intraoperative hemostasis and also stands out for its better prevention of postpartum hemorrhage, better prognosis at follow-up, and lower complication rates.
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Affiliation(s)
- Xuemei Zhang
- Department of Obstetrics and Gynecology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China.,Genetic and Prenatal Diagnosis Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Hongbin Cao
- School of Pharmacy, North Sichuan Medical College, Nanchong, China
| | - Hu Wang
- Department of Obstetrics and Gynecology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xue Li
- Department of Obstetrics and Gynecology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Liping Chen
- Genetic and Prenatal Diagnosis Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Qi Shi
- Department of Obstetrics and Gynecology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China.,Genetic and Prenatal Diagnosis Center, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiaping Li
- Department of Obstetrics and Gynecology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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The Discriminant Use of Intrauterine Balloon Tamponade and Compression Sutures for Management of Major Postpartum Hemorrhage: Comparison of Patient Characteristics and Clinical Outcome. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6648829. [PMID: 33490275 PMCID: PMC7801069 DOI: 10.1155/2021/6648829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 11/17/2022]
Abstract
Background Intrauterine balloon tamponade (IUBT) and compression sutures have been widely used in recent years in the management of postpartum hemorrhage (PPH). However, there is scant literature directly comparing the clinical scenarios that led to the discriminant selection of these management modalities and the direct clinical outcomes. The purpose of this study is to compare the patient characteristics and clinical risk factors that led to the use of IUBT and compression sutures in the management of major PPH as well as the immediate outcome in a retrospective cohort. Methods Patients who had IUBT or compression sutures applied due to major PPH (>1000 ml) from 2014 to 2018 in a single obstetric unit were recruited. The patient characteristics and clinical outcome of the two groups were compared. Results A total of 67 patients had IUBT and 29 patients had compression sutures applied as the first uterine sparing technique. Apart from more vaginal deliveries (25.4% vs. 3.5%) in the IUBT group compared to compression sutures, there were no significant differences between the two groups in terms of patient characteristics. The IUBT group had a slightly higher blood loss at the start of the uterine sparing procedure (239 ml, p = 0.049) and received more transfusions, despite no differences in the total blood loss, hemogloblin level, incidence of coagulopathy, and intensive care unit admission between the two groups. There was no significant difference in the overall success rate between IUBT and compression sutures to control PPH without additional surgical intervention or hysterectomy (73.1% vs. 55.1%, p = 0.15) or the success rate for PPH due to uterine atony (32.8% vs. 20.7%), though IUBT apparently performed better than compression sutures in cases of placenta praevia (77.3% vs. 16.7%, p = 0.01). Blood loss > 1.5 l at the start of the procedure, presence of placenta accreta, and presence of coagulopathy were found to be significant poor prognostic factors for both procedures to control PPH. Conclusions There were no dominating patient characteristics that favoured the selection of either IUBT or compression sutures in the management of severe PPH except for the mode of delivery. Both procedures had equally high overall success rates to control PPH, but IUBT performed better in placenta praevia cases as compared to compression sutures.
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Matsubara S, Takahashi H. Hayman suture versus Bakri balloon: some concerns and clarifications. J Matern Fetal Neonatal Med 2019; 34:1844-1845. [PMID: 31331212 DOI: 10.1080/14767058.2019.1647531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Shigeki Matsubara
- Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
| | - Hironori Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
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Barinov SV, Medjannikova IV, Tirskaya YI, Chuprinin VD, Khilkevich EG, Savelyeva IV, Shamina IV, Borisova AV, Lazareva OV. The use of Zhukovsky vaginal and intrauterine balloons to improve the outcome of postpartum hysterectomies in patients with severe bleeding. J Matern Fetal Neonatal Med 2019; 33:2955-2960. [PMID: 30614315 DOI: 10.1080/14767058.2019.1566309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: To assess the efficacy of a Zhukovsky obstetric double balloon for improving outcomes in women undergoing hysterectomy for postpartum hemorrhage.Materials and methods: This was a randomized controlled study. Participants were divided into two groups to undergo insertion of a Zhukovsky obstetric double balloon prior to hysterectomy (n = 16) or conventional hysterectomy (n = 25).Results: The main reasons for major obstetric hemorrhage were placenta accreta (53.6%), uterine atony (26.8%), uteroplacental apoplexy (14.6%), and amniotic fluid embolism (4.8%). The use of a Zhukovsky obstetric double balloon during postpartum hysterectomy was associated with a 1.7-fold reduction in blood loss and a 2.3-fold reduction in blood loss > 2000 ml compared with conventional hysterectomy.Conclusion: The use of a Zhukovsky obstetric double balloon represents a potent tool for improvement of immediate outcomes of hysterectomy in women with severe postpartum bleeding.
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Affiliation(s)
- Sergey V Barinov
- Russian Ministry of Health, Federal State Budget Educational Institution of Higher Education Omsk State Medical University, Omsk, Russia
| | - Irina V Medjannikova
- Russian Ministry of Health, Federal State Budget Educational Institution of Higher Education Omsk State Medical University, Omsk, Russia
| | - Yuliya I Tirskaya
- Russian Ministry of Health, Federal State Budget Educational Institution of Higher Education Omsk State Medical University, Omsk, Russia
| | - Vladimir D Chuprinin
- Ministry of Health of Russia, National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow, Russia
| | - Elena G Khilkevich
- Ministry of Health of Russia, National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow, Russia
| | - Irina V Savelyeva
- Russian Ministry of Health, Federal State Budget Educational Institution of Higher Education Omsk State Medical University, Omsk, Russia
| | - Inna V Shamina
- Russian Ministry of Health, Federal State Budget Educational Institution of Higher Education Omsk State Medical University, Omsk, Russia
| | - Anna V Borisova
- Russian Ministry of Health, Federal State Budget Educational Institution of Higher Education Omsk State Medical University, Omsk, Russia
| | - Oksana V Lazareva
- Russian Ministry of Health, Federal State Budget Educational Institution of Higher Education Omsk State Medical University, Omsk, Russia
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