Amanecer Rueda-Monsalbe, Jhon Edison Sanabria-Castelblanco, Miguel Ángel Montañez-Aldana
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The MeSh terms used were: “Uterine Atony,” “Postpartum Hemorrhage,” “Immediate Postpartum Hemorrhage,” “Bicornuate Uterus,” “Müllerian Anomalies,” “Müllerian Duct Abnormalities”. Case reports and case series of patients with müllerian malformations and PPH not responding to initial pharmacological management in whom conservative surgical procedures were used to control bleeding were included. A narrative analysis of the findings was carried out based on study characteristics, techniques used and complications.</p><p><strong>Results: </strong>Five studies were selected, 4 case reports and 1 case series which included 12 women with uterine malformations who developed PPH and in whom surgical management (uterine compression sutures) or devices (intrauterine balloon) were used for hemorrhage control. Bleeding was successfully controlled in 11 cases, with hysterectomy required only in one case (8.3 %). No long-term complications were reported.</p><p><strong>Conclusions: </strong>The literature on PPH management in women with müllerian uterine malformations is limited to case reports in which either compression sutures or medical devices such as intrauterine balloons were used. The B-Lynch-type compression suture appears to be a good option for controlling PPH in these women in order to preserve fertility, with a low rate of complications. Further documentation of these types of cases is needed in order to build the evidence regarding the usefulness of this technique for controlling postpartum uterine bleeding in this population.</p>","PeriodicalId":35675,"journal":{"name":"Revista Colombiana de Obstetricia y Ginecologia","volume":"74 2","pages":"153-162"},"PeriodicalIF":0.0000,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/8f/2463-0225-rcog-74-02-3989.PMC10419877.pdf","citationCount":"0","resultStr":"{\"title\":\"Management of postpartum hemorrhage in a patient with bicornuate uterus using the B-Lynch suture. 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The MeSh terms used were: “Uterine Atony,” “Postpartum Hemorrhage,” “Immediate Postpartum Hemorrhage,” “Bicornuate Uterus,” “Müllerian Anomalies,” “Müllerian Duct Abnormalities”. Case reports and case series of patients with müllerian malformations and PPH not responding to initial pharmacological management in whom conservative surgical procedures were used to control bleeding were included. A narrative analysis of the findings was carried out based on study characteristics, techniques used and complications.</p><p><strong>Results: </strong>Five studies were selected, 4 case reports and 1 case series which included 12 women with uterine malformations who developed PPH and in whom surgical management (uterine compression sutures) or devices (intrauterine balloon) were used for hemorrhage control. Bleeding was successfully controlled in 11 cases, with hysterectomy required only in one case (8.3 %). No long-term complications were reported.</p><p><strong>Conclusions: </strong>The literature on PPH management in women with müllerian uterine malformations is limited to case reports in which either compression sutures or medical devices such as intrauterine balloons were used. The B-Lynch-type compression suture appears to be a good option for controlling PPH in these women in order to preserve fertility, with a low rate of complications. 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引用次数: 0
摘要
目的:介绍B-Lynch缝合在双角子宫妇女产后出血中的应用,并对勒氏管异常患者PPH控制策略、产妇出血控制结局及早期和晚期并发症的文献进行综述。材料与方法:一例双角子宫患者剖宫产术后产后出血到地区转诊医院就诊,B-Lynch缝合成功控制。在PubMed, Embase, Medline, Google Scholar和LILACS数据库中进行了搜索。使用的MeSh术语有:“子宫张力失调”、“产后出血”、“产后立即出血”、“双角状子宫”、“勒氏管异常”、“勒氏管异常”。病例报告和病例系列纳入了勒氏管畸形和PPH患者,这些患者对最初的药物治疗没有反应,他们使用保守的外科手术来控制出血。根据研究特点、使用的技术和并发症对研究结果进行了叙述性分析。结果:入选5项研究,4例报告和1个病例系列,包括12例发生PPH的子宫畸形妇女,采用手术治疗(子宫压迫缝合)或宫内球囊术控制出血。11例成功控制出血,仅1例(8.3%)需要子宫切除术。无长期并发症报告。结论:关于勒氏型子宫畸形妇女PPH治疗的文献仅限于使用压缩缝合线或宫内气球等医疗器械的病例报告。b - lynch型压缩缝线似乎是控制这些妇女PPH的一个很好的选择,以保持生育能力,并发症发生率低。需要对这些类型的病例进行进一步的记录,以便建立有关该技术在控制该人群产后子宫出血方面有用性的证据。
Management of postpartum hemorrhage in a patient with bicornuate uterus using the B-Lynch suture. Case report and review of the literature
Objectives: To describe the use of the B-Lynch suture in a case of postpartum hemorrhage of a
woman with bicornuate uterus, and to carry out a review of the literature on PPH control strategies in patients with müllerian anomalies, maternal outcomes in terms of hemorrhage control, as well as early and late complications.
Material and methods: Case report of a patient with bicornuate uterus who presented to a regional referral hospital with postpartum hemorrhage following a cesarean section, which was successfully controlled using the B-Lynch suture. A search was conducted in the PubMed, Embase, Medline, Google Scholar and LILACS databases. The MeSh terms used were: “Uterine Atony,” “Postpartum Hemorrhage,” “Immediate Postpartum Hemorrhage,” “Bicornuate Uterus,” “Müllerian Anomalies,” “Müllerian Duct Abnormalities”. Case reports and case series of patients with müllerian malformations and PPH not responding to initial pharmacological management in whom conservative surgical procedures were used to control bleeding were included. A narrative analysis of the findings was carried out based on study characteristics, techniques used and complications.
Results: Five studies were selected, 4 case reports and 1 case series which included 12 women with uterine malformations who developed PPH and in whom surgical management (uterine compression sutures) or devices (intrauterine balloon) were used for hemorrhage control. Bleeding was successfully controlled in 11 cases, with hysterectomy required only in one case (8.3 %). No long-term complications were reported.
Conclusions: The literature on PPH management in women with müllerian uterine malformations is limited to case reports in which either compression sutures or medical devices such as intrauterine balloons were used. The B-Lynch-type compression suture appears to be a good option for controlling PPH in these women in order to preserve fertility, with a low rate of complications. Further documentation of these types of cases is needed in order to build the evidence regarding the usefulness of this technique for controlling postpartum uterine bleeding in this population.
期刊介绍:
The Revista Colombiana de Obstetricia y Ginecología was founded in January 1949. It is the Federación Colombiana de Asociaciones de Obstetricia y Ginecología"s official periodic publication (formerly known as the Sociedad Colombiana de Obstetricia y Ginecología). It is published quarterly and the following abbreviation should be used when citing the journal: Rev. Colomb. Obstet. Ginecol. The publication is authorized by Mingobierno resolution 218/1950.