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首页> 外文期刊>Open Journal of Obstetrics and Gynecology >Clinical Analysis on the Effectiveness of Conservative Compression Suture Technique to Conserve Fertility on Pernicious Placenta Previa
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Clinical Analysis on the Effectiveness of Conservative Compression Suture Technique to Conserve Fertility on Pernicious Placenta Previa

机译：保守加压缝合技术保护恶性前置胎盘的有效性的临床分析

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Objective : To evaluate the effectiveness of conservative compression surgical suture techniques used for the management of pernicious placenta previa to conserve fertility in the subsequent pregnancies. Study Design: This was a non - comparative retrospective study of 188 patients diagnosed with pernicious placenta previa who underwent cesarean section in The First Hospital of Jilin University, China, from 1 January 2013 to 1 January 2018. Successful group was defined as those in which the intraoperative bleeding was managed by either modified CHO or by B-lynch suture technique and those who had further intervention including hysterectomy were designated as failure group. Results: Out of 217 patients, 188 met inclusion criteria and 29 patients were excluded. In 188 cases, 183 (97.34%) cases successes and 5 (2.65%) cases had hysterectomy. Among included group, 118 patients (62.76%) had undergone emergency cesarean section and 70 patients (37.23%) underwent elective cesarean section. The emergency group had significantly lesser gestation period of gestation at the time of cesarean section (P = 0.021) and lower neonatal weight (P = 0.001) than that of elective group. The estimated blood loss during surgery was 500 - 3200 ml (mean: 925 ml). Additionally, the amount of bleeding was found to be significantly more in patient with intraoperative complication (P = 0.007) and in patient with implanted placenta (P < 0.001). Conclusion: The conservative compression suture technique including modified CHO and B-lynch suture technique during the cesarean delivery is a feasible, safe and effective alternative conservative surgical technique for the management of bleeding in case of pernicious placenta previa. Besides good surgical outcome and proper neonatal result this technique also reduces the rate of hysterectomy, thus conserving the fertility.
机译：目的：评估用于保守性前置胎盘治疗的保守性加压外科缝合技术在以后妊娠中保留生育能力的有效性。 研究设计：这是一项非对照性回顾性研究，研究对象为2013年1月1日至2018年1月1日在中国吉林大学第一医院剖宫产的188例经诊断为恶性前置胎盘的患者。那些术中出血通过改良的CHO或B-lynch缝合技术处理的患者和那些接受进一步手术包括子宫切除术的患者被指定为失败组。 结果：在217位患者中，有188位符合入选标准，而29位患者被排除在外。 188例中，有183例（97.34％）成功切除子宫，其中5例（2.65％）进行了子宫切除术。在包括在内的组中，有118例（62.76％）进行了紧急剖宫产，而70例（37.23％）进行了选择性剖宫产。与选择性组相比，紧急组剖宫产时的妊娠期明显缩短（P = 0.021），新生儿体重较低（P = 0.001）。估计手术期间失血量为500-3200毫升（平均：925毫升）。此外，发现术中并发症的患者和植入胎盘的患者的出血量明显更多（P = 0.007）。 结论：剖宫产术中包括改良的CHO和B-lynch缝合的保守加压缝合技术是一种可行，安全，有效的替代性保守手术技术，用于处理前置恶性前置胎盘出血。除了良好的手术效果和适当的新生儿效果，该技术还降低了子宫切除术的速度，从而保持了生育能力。

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