首页|Bakri球囊治疗胎盘植入产妇自然分娩严重大出血的临床结局

Bakri球囊治疗胎盘植入产妇自然分娩严重大出血的临床结局

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目的:探究Bakri球囊治疗胎盘植入产妇自然分娩产后严重大出血的临床结局.方法:连续收集2016年01月至2020年12月期间在某院自然分娩产后严重大出血产妇170例,所有产妇均给予Bakri球囊止血.收集基线和围产期结局指标,并比较Bakri球囊止血失败和成功产妇、胎盘植入与非胎盘植入产妇的临床围产期结局.结果:在纳入的所有自然分娩产后严重大出血患者中,胎盘植入产妇占比达51.8%(88/170),Bakri球囊止血成功率为87.65%(149/170);而胎盘植入患者止血有效率显著低于非胎盘植入患者(x2=5.73;P=0.017).与止血失败患者相比,止血成功组填塞术前出血量、填塞术后出血量较低,而填塞术间隔时间、球囊置留时间较长(均P<0.05).与非胎盘植入患者相比,胎盘植入组患者在球囊填塞术前出血量、球囊生理盐水量较高;而分娩至填塞术间隔时间较短(均P<0.05).结论:胎盘植入是引起自然分娩产后严重大出血的主要原因.Bakri球囊在胎盘植入患者止血效果稍逊于非胎盘植入患者,但分娩后及早、精准地使用Bakri球囊可能有利于胎盘植入患者止血.
Maternal outcomes after use of Bakri balloon tamponade in the treatment of severe postpartum hemorrhage in women with placenta accreta after natural childbirth
Objective:To explore the maternal outcomes of Bakri balloon tamponade(BBT)in the treatment of severe postpartum hemorrhage in women with placenta accreta after natural childbirth.Methods:A total of 170 women with placenta accreta presenting with severe postpartum hemorrhage(sPPH)after natural childbirth were retrospectively included in our hospital from January 2016 to December 2020.All eligible women received BBT treatment.The clinical baseline characteristics,perinatal outcomes between women with Bakri success and Bakri failure,women with placenta accreta and without placenta accretawere collected and analyzed.Results:Among these women selected,placental implantation accounted for 51.76%(88/170)and BBT showed an effectiveness of 87.65%(149/170).Women with placenta accrete had a lower BBT success rate than those without placenta accrete(x2=5.73,P=0.017).Compared towomen with BBT failure,women with BBT success had a significantly reduced pre/post-BBT blood loss,a prolonged duration from delivery to balloon placement,a prolonged balloon retention time(all P<0.05).Compared to women without placenta accrete,women with placenta accrete showed a significantly higher pre-BBT blood loss and the more volume of physiological saline,but a shorter duration from delivery to balloon placement(all P<0.05).Conclusion:Placenta accrete is the main cause of sPPH in women with natural childbirth.Though BBT showed a slightly lower effectiveness in women with placenta accrete than those without placenta accrete,an early and precise use of Bakri BBT after delivery may contribute to hemostasis success,especially in women with placenta accrete.

placenta accretesevere postpartum hemorrhageBakri balloon tamponadenatural childbirthclinical effective-ness

吴丽婷、陈菲菲、陈苗苗、胡娅萍、王莹

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湖北省妇幼保健院,武汉 430070

胎盘植入 严重大出血 Bakri球囊 自然分娩 临床效果

湖北省自然科学基金湖北省卫生健康委科研项目

1020013802N 2021SFYM021

2024

河南大学学报(医学版)
河南大学

河南大学学报(医学版)

影响因子:0.494
ISSN:1672-7606
年,卷(期):2024.43(4)