Yıl 2019, Cilt 9 , Sayı 3, Sayfalar 32 - 38 2019-09-16

MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment

Emre Volkan KASIMOĞULLARI [1] , Sefik Eser ÖZYÜREK [2] , Tolga KARACAN [3] , Hüseyin KIYAK [4] , Hasan Fehmi YAZICIOGLU [5]


ÖZET
Amaç: Sezaryen ameliyatlarinda karsilasilan ve kontrol edilemeyen kanamalari yonetmede proksimal ve distal
uterin arter ligasyonun terapotik etkinligini tanimlamak
Dizayn: Retrospective study.
Gereç ve Yöntem: Sezaryen ile dogum yapan ve peroperatif kontrol altina alinamayan kanama ile karsilasilan
65 kadin incelendi.Bu hastalarin tedavisinde proksimal uterin arter ligasyonu ,distal uterin arter ligasyonu ya
da hem proksimal hem de uterin arter ligasyonu altta yatan nedenlere gore uygulandi.Bunlara ragmen kanamanin
persiste ettigi olgulara bilateral hipogastrik arter ligasyonu ve kanama halen devam ediyorsa histerektomi
uygulandi.
Sonuçlar: 61 hastanin kanamasi yalnizca uterin arter ligasyonu ile( proksimal uterin arter ligasyonu,distal uterin
arter ligasyonu ya da distal/proksimal uterin arter ligasyonu) kontrol altina alindi.4 akreta tanili hastaya
uterin arter ligasyonuna ek olarak hipogastrik arter ligasyonu ve histerektomi operasyonu uygulandi .Distal
uterin arter ligasyonu cogunlukla uterin atoni nedenli kanamalarda etkin iken ,proksimal uterin arter ligasyonu
ya da distal ve proksimal uterin arter ligasyonu plasenta previa ya da akreta nedenli kanamalarda tedavi
saglamistir.32 akreta tanili hastanin 24 tanesine hem proksimal uterin arter ligasyonu hem distal uterin arter
ligasyonu ,4 tanesine proximal uterin arter ligasyonu, 4 tanesine de histerektomi uygulanmistir.
Tartışma: Sezaryen sirasinda karsilasilan kontrol altina alinamayan kanamalarda uterin arter ligasyon teknigi
basarili,emniyetli ve hayat kurtarici bir islemdir.Ozellikle plasenta akreta ya da previa gibi uterusu korumanin
cok guc oldugu vakalarda bulgularimiz proksimal arter ligasyonunun yararli oldugunu göstermistir.
Anahtar kelimeler: Uterin arter Ligasyonu; Proksimal uterin arter Ligasyonu; Distal uterin arter Ligasyonu;
Obstetrik kanama; Plasenta akreta; Uterin atoni
ABSTRACT
Objective: To describe the therapeutical efficiency of proximal and distal uterine artery ligations performed to
treat uncontrolled bleeding encountered during cesarean section operations.
Design: Retrospective study.
Materials and Method: 65 parturient women delivered by cesarean section. An uncontrolled peroperative
bleedings were encountered. Uterine artery ligations were performed proximally , distally or both segments
depending on the etiology. In cases where the bleeding could not be controlled, hypogastric artery ligations ;
and if persistent, a hysterectomy was performed.
Results: 61 patients were treated with uterine artery ligations (proximal uterine artery ligation, distal uterine
artery ligation or distal/proximal uterine artery ligation). An additional hypogastric artery ligation was required
in 4 accreta cases where a hysterectomy was needed, as well. While distal uterine artery ligations could treat
most atony cases, proximal uterine artery or distal/proximal uterine artery ligation were effective in treating
bleeding due to placenta accreta and/or previa. Of 32 accreta cases; 24 were treated with distal/proximal
uterine artery ligation; 4 with proximal uterine artery ligation, only; and in 4, a hysterectomy was performed.
Discussion: Uterine artery ligation techniques are successful, safe and life saving interventions for treating
uncontrolled bleeding during cesarean section. Especially in conditions where uterus preservation is
considered to be difficult due to placenta accreta and/or previa, our findings show that proximal uterine
artery ligation can provide an added benefit for the patient.
Keywords: Uterine artery ligation,; proximal uterine artery ligation; distal uterine artery ligation; obstetrical
bleeding;placenta accreta;uterine atony
MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment
  • 1. WHO. Maternal mortality in 2000. Estimates developed by WHO, UNICEF, and UNFPA. Geneva: Department of Reproductive Health and Research, World Health Organization; 2004.. 2. Arbab F, Boulie D, Bied V. et al.Uterine rupture in first and second trimestr of pregnancy after in vitro fertilization and embryo transfer.Hum Reprod 1996;11:1120-1122 3. Condous GS, Arulkumaran S. Medical and conservative surgical management of postpartum hemorrhage. J Obstet Gynaecol Can 2003;25(11):931–6. 4. Waters EG. Surgical management of partum hemorrhage with particular reference to ligation of uterine arteries. Am j Obstet Gynecol 1952;64:1143-8., 5. Nelson SH, Suresh NS. Lack of reactivity of uterine arteries from patients with obstetric hemorrhage. 1992;166:1436-43 Acta Obstet Gynecol Scand. 1998;77:186–90 6. Fawcus S, Moodley J. Postpartum haemorrhage associated with caesarean section and caesarean hysterectomy Best Practise &Res. Clin. Obst. and Gynecology 2012, 27: 233-249 7. Fawcus S, Mbombo N, Hofmeyr GJ Saving mothers, Chapter 4. The fifth report of the national confidential enquiry into maternal deaths in South Africa 2008-201. A short report. Pretoria: Department of Health. 2012. 8. Fawcus S & Mbombo N. Deaths from haemorrhage associated with caesarean section in South Africa, 2009. Abstract FIGO Cape Town, South Africa. 9. Zwart JJ, Richters JM, Ory F et al. Severe maternal morbidity during pregnancy, delivery, and puerperium in the Netehrlands: a nationwide population-based study of 371000 pregnancies. BJOG 2008: 115:842-850.
Birincil Dil tr
Bölüm Orjinal Çalışma
Yazarlar

Yazar: Emre Volkan KASIMOĞULLARI

Yazar: Sefik Eser ÖZYÜREK

Yazar: Tolga KARACAN

Yazar: Hüseyin KIYAK

Yazar: Hasan Fehmi YAZICIOGLU

Tarihler

Yayımlanma Tarihi : 16 Eylül 2019

Bibtex @araştırma makalesi { bozoktip620617, journal = {Bozok Tıp Dergisi}, issn = {2146-4006}, eissn = {2148-2438}, address = {}, publisher = {Bozok Üniversitesi}, year = {2019}, volume = {9}, pages = {32 - 38}, doi = {}, title = {MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment}, key = {cite}, author = {KASIMOĞULLARI, Emre Volkan and ÖZYÜREK, Sefik Eser and KARACAN, Tolga and KIYAK, Hüseyin and YAZICIOGLU, Hasan Fehmi} }
APA KASIMOĞULLARI, E , ÖZYÜREK, S , KARACAN, T , KIYAK, H , YAZICIOGLU, H . (2019). MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment. Bozok Tıp Dergisi , 9 (3) , 32-38 . Retrieved from https://dergipark.org.tr/tr/pub/bozoktip/issue/48757/620617
MLA KASIMOĞULLARI, E , ÖZYÜREK, S , KARACAN, T , KIYAK, H , YAZICIOGLU, H . "MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment". Bozok Tıp Dergisi 9 (2019 ): 32-38 <https://dergipark.org.tr/tr/pub/bozoktip/issue/48757/620617>
Chicago KASIMOĞULLARI, E , ÖZYÜREK, S , KARACAN, T , KIYAK, H , YAZICIOGLU, H . "MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment". Bozok Tıp Dergisi 9 (2019 ): 32-38
RIS TY - JOUR T1 - MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment AU - Emre Volkan KASIMOĞULLARI , Sefik Eser ÖZYÜREK , Tolga KARACAN , Hüseyin KIYAK , Hasan Fehmi YAZICIOGLU Y1 - 2019 PY - 2019 N1 - DO - T2 - Bozok Tıp Dergisi JF - Journal JO - JOR SP - 32 EP - 38 VL - 9 IS - 3 SN - 2146-4006-2148-2438 M3 - UR - Y2 - 2019 ER -
EndNote %0 Bozok Tıp Dergisi MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment %A Emre Volkan KASIMOĞULLARI , Sefik Eser ÖZYÜREK , Tolga KARACAN , Hüseyin KIYAK , Hasan Fehmi YAZICIOGLU %T MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment %D 2019 %J Bozok Tıp Dergisi %P 2146-4006-2148-2438 %V 9 %N 3 %R %U
ISNAD KASIMOĞULLARI, Emre Volkan , ÖZYÜREK, Sefik Eser , KARACAN, Tolga , KIYAK, Hüseyin , YAZICIOGLU, Hasan Fehmi . "MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment". Bozok Tıp Dergisi 9 / 3 (Eylül 2019): 32-38 .
AMA KASIMOĞULLARI E , ÖZYÜREK S , KARACAN T , KIYAK H , YAZICIOGLU H . MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment. Bozok Tıp Dergisi. 2019; 9(3): 32-38.
Vancouver KASIMOĞULLARI E , ÖZYÜREK S , KARACAN T , KIYAK H , YAZICIOGLU H . MEDİKAL TEDAVİYE YANITSIZ OBSTETRİK KANAMALI OLGULARDA SIRALI UTERİN ARTER DEVASKÜLARİZASYON SONUÇLARI Stepwise Uterine Artery Ligation Results In Patients With Postpartum Bleeding Unresponsive To Medical Treatment. Bozok Tıp Dergisi. 2019; 9(3): 38-32.