Novel combined strategy of obstetric haemorrhage management during caesarean section using intrauterine balloon tamponade
| Autor: | S. V. Barinov, I. V. Medyannikova, Yakov G Zhukovsky, Vladimir Terent'evich Dolgikh |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Hysterectomy law.invention Randomized controlled trial Pregnancy law medicine Humans Caesarean section Uterine Balloon Tamponade medicine.diagnostic_test Cesarean Section business.industry Postpartum Hemorrhage Obstetrics and Gynecology Blood Coagulation Disorders medicine.disease Combined Modality Therapy Hemostasis Surgical Thromboelastography Thrombelastography Surgery Treatment Outcome medicine.anatomical_structure Pediatrics Perinatology and Child Health Female Tamponade Uterine cavity business |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. :1-21 |
| ISSN: | 1476-4954 1476-7058 |
| DOI: | 10.3109/14767058.2015.1126242 |
| Popis: | The aim of this trial was to evaluate the performance of a combined strategy of postpartum haemorrhage management, based upon thromboelastographic (TEG) assessment of coagulation, early surgical haemostasis and mechanical compression of the uterine wall combined with uterine cavity draining, via intrauterine balloon tamponade (BT).We carried out an open controlled trial, which included 119 women with obstetric haemorrhage (main group - combined strategy: n = 90, control group - conventional strategy: n = 29). The combined strategy included three essential components: (1) early surgical haemostasis, (2) mechanical pressure upon the uterine wall and draining of the uterine cavity via BT and (3) treatment of blood coagulation disorders identified via TEG.The combined haemorrhage management strategy resulted in significantly lower number of peripartum hysterectomies compared with standard management (4.44% versus 31.03%, respectively, p = 0.02). Blood loss of 2000 ml occurred significantly less common in the main group compared with the control group (16.2% versus 27.6%, respectively, p = 0.03). Mean total blood loss after combined management was significantly lower than after the standard approach (2502 ± 203 ml versus 1836 ± 108 ml, p = 0.04).The proposed combined strategy of obstetric haemorrhage management represents a powerful tool for fertility-sparing treatment of this life-threatening condition. |
| Databáze: | OpenAIRE |
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