Fertility rate and subsequent pregnancy outcomes after conservative surgical techniques in postpartum hemorrhage: 15 years of literature  

Oleh:

Gizzo, Salvatore ; Saccardi, Carlo ; Patrelli, Tito Silvio ; Di Gangi, Stefania ; Breda, Elisa

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 99 no. 07 (Jun. 2013), page 2097-2107.
Topik: Uterine atony; uterine vessel ligation; hypogastric artery ligation; pelvic vessel embolization; uterine compression sutures

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2013.04 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

Objective To investigate the most appropriate surgical technique for optimizing hemostasis and preservation of subsequent fertility after postpartum hemorrhage (PPH). Design Systematic review of the literature. Setting Not applicable. Patient(s) None. Intervention(s) Review of MEDLINE, EMBASE, ScienceDirect, and the Cochrane Library. Main Outcome Measure(s) Comparison of the effectiveness of conservative surgical techniques, separately or together, with respect to success rate (ability to stop bleeding and preserve the uterus), fertility rate (subsequent pregnancies or the return of regular menstrual cycles), complication rate of the procedure, and the outcomes of subsequent pregnancies in terms of type of delivery and eventual delivery complications. Result(s) Compressive sutures and vessel embolization may be considered life-saving procedures by achieving the best hemostatic efficacy. Data on restoration of menses and pregnancy rates after these procedures are limited by short-term follow-up and by the paucity of studies, especially for vascular ligation. Conclusion(s) Pelvic vessel embolization and compressive sutures are associated with high rates of restoration of regular menses and successive pregnancies, even if the former is burdened by an increased rate of placental disorders and fetal growth restriction and the latter by an increased risk of cesarean deliveries and PPH recurrence. Randomized trials would be desirable to define the best management of PPH.

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