MEHMET ŞİMŞEK, Remzi ATILGAN, Uğur ORAK, SALİH BURÇİN KAVAK, Zehra Sema ÖZKAN, İsmail DEMİREL, HAKAN ARTAŞ, EKREM SAPMAZ

Use of Uterine Balloon Tamponade For Managing Placental Invasion Anomalies: Retrospective Study

Amaç: Plasental invazyon anomalisi tespit edilen olguların konservatif yönetimi. Gereç ve Yöntem: Hastanemizde plasental invazyon anomalisi tanısı alan ve tedavi edilen olguların klinik karekteristiklerinin analizi yapıldı. Bulgular: İki yıllık periyotta toplam on olgu plasental invazyon anomalisi tanısı aldı. Yedi olgu plasenta akreta ve üç olgu plasenta perkretaOrtalama kan kaybı ve transfüzyon miktarı sırasıyla 1950 (±646) mL ve 5.7 (±3.8) unite idi. Yedi olguda Bakri balon uygulaması postpartum hemorajiyi control altına aldı; fakat bir olguda uterin arter ligasyonu, diğer bir olguda ise B-Lynch sütürasyonu + uterin arter ligasyonu ile birlikte Bakri balon uygulamasına ihtiyaç duyuldu. Diğer bir kare sütür + foley katater-kondom tamponadı ile birlikte Affronti sütürleri uygulanarak kanama kontrolü sağlandı. Uterin balon tamponad uygulanan olgulardan hiçbiri histerektomiye gitmezken, B-Lynch sütürasyon + uterin arter ligasyonu yapılan bir olguya koagülopatiden dolayı acil histerektomi yapıldı. Olguların hiçbirinde postpartum enfeksiyon, mortalite ve pelvik organ yaralanması olmadı. Sonuç: Plasental invazyon anomalisi tanısı konulan hastaların konservatif yönetiminde UBT nin kullanımı hemorajiyi control altına alabilirfertiliteyi koruyabilir. idi. ve

Plasental İnvazyon Anomalili Olguların Yönetiminde Uterin Balon Tamponad Kullanımı

Objective: Conservative management of cases detected with placental invasion anomaly. Material and Method: Analysis of the clinical characteristics of the cases, diagnosed with placental invasion anomalies, treated in our hospital. Results: A total of ten patients diagnosed with placental invasion anomaly during two years period. Seven cases were placenta accreta and three cases were placenta percreta. The mean estimated blood loss and blood transfusion amount were 1950 (±646) mL and 5.7 (±3.8) units respectively. Whileseven cases, Bakri balloon application controlled postpartum hemorrhage (PPH); but one case needed uterine artery ligation and the other one case needed B-lynch suturation + uterine artery ligation in addition to Bakri balloon application. In the remaining one case, hemorrhage was controlledapplication of square sutures+ condom combined foley catheter tamponade + Affronti sutures. While none of the cases, where only uterine balloon tamponade (UBT) is applied, required hysterectomy, but the case received B-lynch suturation + uterine artery ligation required urgent hysterectomy due to coagulopathy. None of our cases experienced postpartum infection, mortality and pelvic organ injury. Conclusion: In conservative management of the patients diagnosed with placental invasion anomaly, use of UBT is effective for providing hemorrhage control and protection of fertility. in by

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