Zhonghua fu chan ke za zhi
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Zhonghua Fu Chan Ke Za Zhi · Oct 2016
[Multiposition spiral suture of the lower uterine segment: a new technique to control the intraoperative bleeding of pernicious placenta previa].
Objective: To explore the efficacy and safety of multiposition spiral suture of the lower uterine segment, a new technique to control the intraoperative bleeding of pernicious placenta previa(PPP). Methods: From May 2014 to May 2015, 38 patients were diagnosed PPP in Tongji Hospital and cesarean sections were performed. After removing the placenta, multiposition spiral suture was used when massive bleeding occurred, and bilateral descending branches of uterine artery ligation was conducted when necessary. ⋯ No complication was found in 6 months after the operation. Conclusions: The multiposition spiral suture technique is a simple, safe and effective way to control the massive bleeding in the cesarean section of PPP patients. It is also beneficial for the recovery of the uterus.
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Zhonghua Fu Chan Ke Za Zhi · Sep 2016
[Application of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa complicated with placenta accreta].
Objective: To investigate the value of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa with placenta accreta. Methods: From January 2015 to February 2016, 24 cases of complete placenta previa with placenta accreta were treated with temporary balloon occlusion of the abdominal aorta(the study group)before cesarean, and 24 cases of complete placenta previa with placenta accreta did not receive balloon occlusion(the control group). The operation time, intraoperative blood loss, intraoperative blood transfusion volume, the perioperative hemoglobin level, the hysterectomy rate and the related complications were compared retrospectively. ⋯ Two cases(8%,2/24)in the control group had hysterectomy, while none in the study group, there was no statistical significance(P= 0.489). Conclusions: Temporary balloon occlusion of the abdominal aorta can effectively reduce blood loss and blood transfusion in the treatment of complete placenta previa with placenta accreta, but there is still the risk of continuing bleeding after releasing the balloon. Other methods of hemostasis might be needed.
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To investigate the factors affecting the vaginal birth after cesarean (VBAC). ⋯ The maternal age, the BMI before pregnancy, the Bishop score before labor and the birth weight of neonate are the main factors affecting VBAC.
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Zhonghua Fu Chan Ke Za Zhi · Aug 2016
Multicenter Study[Multi-centric clinical study of trial of labor after cesarean section].
To study the feasibility and safety of trial of labor after cesarean section (TOLAC). ⋯ The rate of pregnancy after cesarean section is increasing year by year, and the will of vaginal birth is increasing, while it still are generally low. TOLAC is safe and feasible, but also significantly higher risk, strictly labor monitoring and can proceed fast cesarean delivery in delivery room is an important guarantee of safe delivery.
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Zhonghua Fu Chan Ke Za Zhi · Aug 2016
Controlled Clinical Trial[Clinical study on vaginal birth after cesarean].
To investigate the incidence and pregnant outcome on vaginal birth after cesarean (VBAC). ⋯ The majority of patients choose ERCS rather than TOLAC. It's important to assess the indications and contraindications of patients for the successful VBAC, and to monitor maternal and fetal conditions during the delivery process. The premise of TOLAC is a comprehensive understanding of closely monitoring the progress of delivery. Compared with the ERCS, VBAC could reduce patients' postpartum hemorrhage and hospitalization duration, improve the outcomes of pregnancy, and the cesarean section rate could be reduced.