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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 09

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Ginecol Obstet Mex 2019; 87 (09)

Control of postpartum hemorrhage employing selective uterine artery ligation. Seven years experience

Posadas-Nava A, Moreno-Santillán AA, Celis-González C, Cruz-Martínez E

Language: Spanish
References: 23
Page: 576-582
PDF size: 350.07 Kb.


ABSTRACT

Objective: To report our experience in the use of selective uterine artery ligation (Posadas technique) as a conservative method for the management of the postpartum hemorrhage (PPH).
Materials and Methods: Retrospective and descriptive study, carried out in patients with a diagnosis of obstetric hemorrhage resistant to treatment with uterotonics, in whom the Posadas technique is practiced, attended in the High Specialty Medical Unit of Gynecology and Obstetrics Dr. Luis Castelazo Ayala , from October 1, 2011 to August 31, 2018. General obstetric variables were registered, indication of the surgical intervention, complications, complications, estimated time of the technique, amount of bleeding and requirement of some additional adjuvant procedure.
Results: Selective ligation of uterine arteries (posed techniques) was performed on 750 patients with obstetric hemorrhage resistant to drugs to uterotonic treatment. There were 415 cases with postpartum obstetric hemorrhage and 335 post-cesarean hemorrhage. The average time of the Posadas technique was 6.6 ± 2.3 minutes and the average bleeding rate was 1299 ± 688 mL. In 724 (96.4%) patients the control of bleeding was controlled and in 23 complementary procedures were necessary. Three patients required hysterectomy due to persistent bleeding and hemodynamic instabil- ity. The main transoperative complications were: hematoma of the broad ligament (n = 10) and tear of the uterine artery (n = 3).
Conclusions: Selective ligation of uterine arteries (Posadas technique) is a simple, fast, effective and safe technique for the conservative treatment of obstetric hemorrhage.


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