使用 Bakri 球囊处理产后出血:调查胎盘滞留风险。

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL American Journal of Case Reports Pub Date : 2024-10-23 DOI:10.12659/AJCR.945672
Shohei Tanabe, Yutoku Shi
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引用次数: 0

摘要

背景 受孕产物残留(RPOC)是二胎分娩或妊娠终止后的一种罕见并发症,通常会导致大出血。通过超声或 CT 诊断,RPOC 需要根据子宫内膜厚度进行手术干预。风险因素包括二胎流产和使用胎盘钳。我们报告了一例在足月分娩时使用巴克里球囊治疗无张力出血后,产后 1 个月被诊断为 RPOC 的病例。病例报告 患者是一名 32 岁女性,有 4 次怀孕和 3 次分娩史,通过冷冻胚胎移植受孕,这是她第一次接受不孕症治疗。妊娠 36 周时,血检显示血红蛋白水平为 10.4 g/dl。她在 38 周 2 天时经阴道分娩,但产后子宫收缩不良,导致大量出血。使用催产素和子宫按摩都未能改善宫缩,因此为她植入了巴克里球囊。总失血量为 2263 毫升,输了 6 个单位的红细胞。第二天,取出了巴克里球囊,产后第 5 天出院前,超声波检查证实没有胎盘滞留。然而,在产后 1 个月的检查中,诊断出胎盘滞留,需要进一步干预。患者拒绝随访。结论 我们遇到了一例使用巴克里球囊 1 个月后发生 RPOC 的病例。虽然两者之间的关系尚不清楚,但今后最好避免使用这种治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Postpartum Hemorrhage Management with Bakri Balloon: Investigating Retained Placenta Risk.

BACKGROUND Retained products of conception (RPOC) is a rare complication following second-trimester delivery or pregnancy termination, often leading to significant hemorrhage. Diagnosed via ultrasound or CT, RPOC requires surgical intervention based on endometrial thickness. Risk factors include second-trimester abortion and use of placental forceps. We report a case of RPOC diagnosed 1 month postpartum after using a Bakri balloon for atonic hemorrhage during full-term delivery. CASE REPORT The patient, a 32-year-old woman with a history of 4 pregnancies and 3 births, conceived via frozen embryo transfer, which was her first infertility treatment. At 36 weeks of gestation, blood tests revealed a hemoglobin level of 10.4 g/dl. She delivered vaginally at 38 weeks 2 days, but postpartum uterine contractions were poor, leading to significant bleeding. Oxytocin administration and uterine massage failed to improve contractions, so a Bakri balloon was inserted. The total blood loss was 2263 cc, and 6 units of RBCs were transfused. The next day, the Bakri balloon was removed, and ultrasonography confirmed the absence of retained placenta before discharge on postpartum day 5. However, at her 1-month checkup, a retained placenta was diagnosed, requiring further intervention. The patient declined follow-up. CONCLUSIONS We encountered a case of RPOC 1 month after using a Bakri balloon. Although the relationship between the 2 remains unclear, it may be preferable to avoid such treatment in the future.

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来源期刊
American Journal of Case Reports
American Journal of Case Reports Medicine-Medicine (all)
CiteScore
1.80
自引率
0.00%
发文量
599
期刊介绍: American Journal of Case Reports is an international, peer-reviewed scientific journal that publishes single and series case reports in all medical fields. American Journal of Case Reports is issued on a continuous basis as a primary electronic journal. Print copies of a single article or a set of articles can be ordered on demand.
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