Prophylactic hypogastric artery ligation in surgery for placental invasion disorders
Abstract
Objective: To determine the effectiveness of prophylactic hypogastric artery ligation (HAL) on the bleeding control in surgeries of placental invasion anomalies. Study design: In this study, an evaluation was made of the effects on bleeding of prophylactic HAL applied before hysterectomy in cases of placental invasion anomalies. A total of 45 pregnant patients with placental invasion anomalies were examined retrospectively. In Group 1 (n=19) hysterectomy alone was applied in the surgical treatment and in Group 2 (n=26), prophylactic HAL was applied before hysterectomy. The results were compared with evaluation of morbidities, particularly bleeding. Results: Statistically significantly higher values were determined in Group 1 compared to Group 2 in respect of estimated blood loss (3183 vs 2204 ml, P<0.001), amount of fluid drainage (2346 vs 700 ml, P<0.001), and mean units of packed red cells and thrombocytes transfused (5.8 vs 3.3 units, P<0.001 and 3.9 vs 2.5 units, P<0.001 respectively). The hCO3 level was statistically significantly lower in Group 1 (16.3 meq/L in Group 1, 19.2 meq/L in Group 2) (P=0.003). Conclusions: Prophylactic HAL has a protective effect on bleeding in operations of placental invasion anomalies and may be used in cases in which balloon occlusion of the hypogastric artery can not be performed.
Source
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINEVolume
9Issue
8Collections
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