The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial
The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial
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DOI：
10.1080/1528008x.2018.1429981
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发表时间：
2019-10-18
影响因子：
1.8
通讯作者：
Momtaz, Mohamed
中科院分区：
文献类型：
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作者：
Hussein, Ahmed M.;Dakhly, Dina Mohamed Refaat;Momtaz, Mohamed
目的：探讨双侧髂内动脉（IIA）结扎在剖宫产子宫切除术中减少异常侵入性胎盘（AIP）出血量的作用。方法：在这项平行随机对照试验中，入选了57名超声特征提示AIP的孕妇。他们被随机分为两组；IIA组（n = 29例）行双侧IIA结扎后剖宫产切除术，对照组（n = 28例）仅行剖宫产切除术。主要结果是两组估计术中出血量的差异。结果：两组术中估计失血量无显著差异（1632 +/- 804 vs 1698 +/- 1251， p值0.83）。手术时间（分钟）(223 +/- 66 vs 171 +/- 41.4， p值。001)，两组间差异显著。结论：在剖宫产子宫切除术的AIP病例中，不建议将双侧髂内动脉结扎作为常规做法，以减少术中出血量。
Objective: To identify the role of bilateral internal iliac artery (IIA) ligation on reducing blood loss in abnormally invasive placenta (AIP) undergoing caesarean hysterectomy. Methods: In this parallel-randomized control trial, 57 pregnant females with ultrasound features suggestive of AIP were enrolled. They were randomized into two groups; IIA group (n = 29 cases) performed bilateral IIA ligation followed by caesarean hysterectomies, while Control group (n = 28 cases) underwent caesarean hysterectomy only. The main outcome was the difference in the estimated intraoperative blood loss between the two groups. Results: There was no significant difference between the two groups regarding the intraoperative estimated blood loss (1632 +/- 804 versus 1698 +/- 1251, p value .83). The operative procedure duration (minutes) (223 +/- 66 versus 171 +/- 41.4, p value .001) varied significantly between the two groups. Conclusions: Bilateral internal iliac artery ligation, in cases of AIP undergoing caesarean hysterectomy, is not recommended for routine practice to minimize blood loss intraoperatively.