ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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Postpartum Kanamalarda Uterus Koruyucu Cerrahi Tedavilerin Uzun Dönem Sonuçları ve Fertilite Üzerine Etkileri
Long-Term Results of Uterine-Sparing Surgical Treatments in Postpartum Hemorrhages and Their Effects on Fertility
Received Date : 06 Oct 2022
Accepted Date : 26 Oct 2022
Available Online : 28 Nov 2022
Özet PDF Benzer Makaleler
Şeyma OSMANLIOĞLUa, Murat SÖNMEZERb
aAnkara Medipol Üniversitesi Tıp Fakültesi, Doğum ve Kadın Hastalıkları ABD, Ankara, Türkiye bAnkara Üniversitesi Tıp Fakültesi, Doğum ve Kadın Hastalıkları ABD, Ankara, Türkiye
Doi: 10.24074/tjrms.2022-93746 - Makale Dili: TR
TJRMS. 2022;6(3):203-8.
ÖZET
Postpartum kanama (PPK), maternal morbidite ve mortalitenin önemli bir nedeni olup, dünya çapındaki tüm anne ölümlerinin dörtte birinden fazlasının PPK nedenli olduğunu tahmin edilmektedir. Şiddetli PPK tanısının ardından uterus masajı, farmakolojik ajanlar ve intrauterin balon tamponadı ile kanama kontrolü sağlanamıyorsa, gecikmeden cerrahi yöntemlere başvurulması önerilmektedir. Hemostatik destek dikişi (B-Lynch veya modifiye edilmiş sıkıştırma sütürleri), uterin arterlerin bilateral ligasyonu, hipogastrik (internal iliak) arterlerin bilateral ligasyonu veya radyolojik arter embolizasyonu bir sonraki adım olarak kullanılabilir. Bu makalede PPK sonrası uterin koruyucu cerrahi girişimlerin adet döngüsü ve doğurganlık üzerindeki kısa ve uzun vadedeli etkileri detaylı olarak incelenmiştir. Yapılan bireysel çalışmaların tasarımı ve sonuç ölçümleri farklılık göstermekle birlikte elde edilen sonuçlar genel olarak tutarlıdır. Şiddetli PPK’nın kontrolünde kullanılan radyolojik veya cerrahi yöntemler, uzun vadede olumsuz fertilite sonuçları göstermemektedir.
Anahtar Kelimeler: Postpartum kanama; cerrahi işlemler; B-Lynch; uterin arter ligasyonu; radyolojik arter embolizasyonu; fertilite
ABSTRACT
Postpartum hemorrhage (PPH) is an important cause of maternal morbidity and mortality, and it is estimated that more than a quarter of all maternal deaths worldwide are due to PPH. If bleeding cannot be controlled with uterine massage, pharmacological agents, and intrauterine balloon tamponade after the diagnosis of severe PPH, it is recommended to resort to surgical methods without delay. Hemostatic support suture (B-Lynch or modified compression sutures), bilateral ligation of uterine arteries, bilateral ligation of hypogastric (internal iliac) arteries, or radiological artery embolization may be used as the next step. In this article, the short and long-term effects of uterine-sparing surgical interventions after PPH on menstrual cycle and fertility will be discussed in detail. Although the design and outcome measures of individual studies vary, the results are generally consistent. The radiological or surgical methods used in the control of severe PPH show no long-term adverse fertility outcomes.
Keywords: Postpartum hemorrhage; surgical procedures; B-Lynch; uterine artery ligation; radiological artery embolization; fertility
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