- 期刊
Successful Use of Gauze Packing to Arrest Postpartum Hemorrhage Due to Placenta Previa
以紗布卷填充法治療前置胎盤之產後大出血
摘要
產後大出血是造成產婦罹病及死亡常見的原因。造成產後大出血的原因包括產道裂傷、胎盤滯留、子宮收縮無力及孕婦本身凝血功能異常。在排除孕婦本身凝血功能異常、產道裂傷、胎盤滯留後，我們常以按摩子宮及藥物治療子宮收縮無力。對於按摩子宮及藥物治療無效者我們可考慮以手術方式結紮循環至子宮的動脈血管如子宮動脈、腹下動脈。對於結紮血管無效者或執行上有困難者大部份的醫師會考慮切除子宮。子宮切除雖然可以停止產後大出血繼續發生，但相對的，對婦女而言也就失去生育能力。在此我們以紗布卷填充子宮的方式治療前置胎盤個案於生產後發生子宮收縮不良之產後大出血，希望能提供產後大出血的另一種治療之選擇。
並列摘要
Postpartum hemorrhage immediately following delivery is a consequence of excessive bleeding from the placental implantation site, lacerating wounds of the genital tract and adjacent structures, or both. In the United Kingdom, half of maternal deaths from hemorrhage are due to postpartum events(superscript [1]) Uterine atony, degrees of retained placenta and genital tract lacerations account for most cases of postpartum hemorrhage. When postpartum hemorrhage occurs, the possibility of retained placental fragments, genital tract trauma and coagulopathy must be ruled out first. If only uterine atony is noted, it is managed by uterine massage, pharmacological methods, and artery ligation. When those methods fail to stop bleeding, the obstetrician often considers a cesarean hysterectomy. However, a hysterectomy ends a woman's child-bearing ability. Here, we present two cases of postpartum hemorrhage due to placenta previa which were successfully treated with gauze packing thus avoiding a hysterectomy.