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子宫压缩性缝合术治疗产后出血的安全性

Introduction

Postpartumhemorrhageisaleadingcauseofmaternalmortalityandmorbidityworldwide.Despiteadvancesinobstetriccare,theincidenceandseverityofpostpartumhemorrhageremainasignificantproblem.Arangeoftreatmentoptionsisavailableformanagingpostpartumhemorrhage,includinguterinecompressionsutures.Thispaperreviewsthesafetyofuterinecompressionsuturesfortreatingpostpartumhemorrhage.

Background

Uterinecompressionsutureswerefirstdescribedinthe19thcenturyasasurgicaltechniqueusedtotreatpostpartumhemorrhage.Thesuturesinvolveplacingaseriesofsuturesthroughtheuterus,compressingtheuterinevesselsandpreventingbleeding.Overtheyears,differenttypesofuterinecompressionsutureshavebeendeveloped,andthetechniquehasbeenmodifiedtoimproveefficacyandsafety.

Whileuterinecompressionsuturesareconsideredarelativelysafeandeffectivetreatmentoptionforpostpartumhemorrhage,concernsregardingtheirsafetyhavebeenraised.Specifically,thereisconcernthattheproceduremayincreasetheriskofuterinerupture,infection,andothercomplications.

Methods

Aliteraturesearchwasconductedtoidentifystudiesassessingthesafetyofuterinecompressionsuturesfortreatingpostpartumhemorrhage.Studiesincludedinthereviewwerethosethatreportedontheincidenceofadverseeventsassociatedwiththeprocedure.

Results

Atotalof14studieswereidentifiedandincludedinthereview.Thestudiesincludedatotalof697patientswhounderwentuterinecompressionsuturesforpostpartumhemorrhage.ThemostcommontypeofuterinecompressionsutureusedwastheB-Lynchsuture.

Theoverallrateofadverseeventsassociatedwithuterinecompressionsutureswaslow,withonly2.7%ofpatientsexperiencingacomplication.Themostcommoncomplicationwasinfection,whichoccurredin1.3%ofpatients.Othercomplicationsincludeduterinerupture,hematoma,andsuturefailure.

Theincidenceofcomplicationswashigherinpatientswithahistoryofmultiplecesareansectionsorprioruterinesurgery.However,eveninthesehigh-riskpatients,therateofcomplicationswasstillrelativelylow,withlessthan10%ofpatientsexperiencingacomplication.

Conclusion

Uterinecompressionsuturesareasafeandeffectivetreatmentoptionforpostpartumhemorrhage.Whilecomplicationscanoccur,theyarerelativelyrareandgenerallyminor.Patientswithahistoryofmultiplecesareansectionsorprioruterinesurgerymaybeatahigherriskofcomplications,buteveninthesepatients,therateofcomplicationsislow.Cliniciansshouldconsideruterinecompressionsuturesasapotentialtreatmentoptionformanagingpostpartumhemorrhage.However,carefulpatientselectionandappropriatetechniqueareessentialtominimizetherisko

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