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外文期刊>Pan African Medical Journal
>Nécrose utérine suite à une combinaison de compressions utérines et de ligature vasculaire lors d'une hémorragie post-partum: rapport de cas
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Nécrose utérine suite à une combinaison de compressions utérines et de ligature vasculaire lors d'une hémorragie post-partum: rapport de cas
Delivery hemorrhage is the leading cause of maternal mortality in Morocco. It is an obstetric emergency requiring early, effective and multidisciplinary management in patients with severe postpartum bleeding resistant to medical treatment. Advances in interventional radiology and especially, in surgical techniques have provided safe and effective alternatives to hemostasis hysterectomy . We here report a case of uterine necrosis following conservative surgical treatment of delivery hemorrhage based on B-Lynch uterine compression suture combined with Tsirulnikov triple vascular ligation. The patient had sepsis on day 4 after delivery associated with fever and pelvic pain and biological inflammatory syndrome which worsened 48 hours after the onset of abdominal contracture. Abdomopelvic scanner, showed gas bubbles in the uterine myometer suggestive of necrosis. Exploratory laparotomy was performed, which objectified complete necrosis of the uterus. Uterine compression sutures are surgical techniques which play a major role in the therapeutic armamentarium of postpartum hemorrhage during cesarean section. It allows, in addition to or as an alternative to vascular ligation, the preservation of patient's fertility, but it also requires maximum caution and monitoring of complications, the most serious of which is uterine necrosis.Copyright: Kamal EL Moussaoui et al.
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机译：交付出血是摩洛哥孕产妇死亡率的主要原因。它是一种重生应急，需要早期，有效和多学科管理，患有严重的产后对医疗抗性的患者。介入放射学的进展，特别是在手术技术中，为止血子宫切除术提供了安全有效的替代品。我们在这里举报了基于B-Lynch子宫压缩缝合的输送出血的保守手术治疗后的子宫坏死病例，与Tsirulnikov三重血管连接相结合。患者在第4天患有败血症，与发烧和盆腔疼痛和生物炎症综合征相关，腹部挛缩后48小时恶化。腹腔镜扫描仪，在子宫测压器中显示出气泡，暗示坏死。进行了探索性剖腹手术，其对子宫的完全坏死进行了描述。子宫压缩缝合线是手术技术，其在剖宫产期间在产后出血的治疗武器中起主要作用。除了血管结扎之外还允许保护患者的生育能力，但它还需要最大限度地谨慎和监测并发症，最严重的是子宫坏死。柔毛：Kamal El Moussaou等人。
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