Devenir obstétrical après plicatures utérines dans le traitement de l’hémorragie de la délivrance : suivi à long terme de 40 cas

Conclusion Le pronostic obstétrical est conservé à distance d’une plicature utérine. Les techniques transfixiantes pourraient être à l’origine d’un plus grand nombre de complications ischémiques et infectieuses. Une évaluation des techniques chirurgicales selon leur caractère transfixiant ou non sur une large cohorte est nécessaire pour l’évaluation de l’influence de la technique sur la fertilité et les complications post-opératoire. Objective Uterine atony is the first cause of postpartum hemorrhage. In caesarean section, different techniques of uterine compression suture exist when uterotonic drugs fail. Their effectiveness is shown but little data on their effects on subsequent pregnancies are available. The aim of this work is analyze of the obstetrical long-term consequences after uterine compression suture. Patients and methods This is a retrospective study of 40 cases of uterine compression suture performed in a level III maternity, between 2004 and 2010. The main objective is the evaluation of the obstetrical prognosis of subsequent pregnancies. The efficacy and safety of surgical techniques, according to their transfixing character or not, were analyzed. Results Eleven pregnancies after uterine compression suture were reported among 14 women whishing another pregnancy. The median time to be pregnant was 27 months (6–78 months). Nine pregnancies were conducted at term. One case of intrauterine growth restriction and a moderate prematurit...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research