Application value of uterine balloon compression, uterine artery ligation and B-Lynch suture in refractory postpartum hemorrhage after cesarean section

Objective To investigate the clinical application value of uterine balloon compression, uterine artery ligation and B-Lynch suture in refractory postpartum hemorrhage after cesarean section.

MethodsA total of 115 women with refractory postpartum hemorrhage after cesarean section were treated with three different surgical methods of uterine balloon compression, uterine artery ligation and B-Lynch suture.When one surgical method could not effectively stop bleeding, the operators chose the combined method to treat postpartum bleeding according to their experience.According to the surgical method, the patients were divided into the single surgery group(including uterine balloon compression group, uterine artery ligation group and B-Lynch suture group) and combined surgery group(including uterine artery ligation+B-Lynch suture group, uterine artery ligation+balloon compression group and balloon compression+B-Lynch suture group).The clinical effects between the single surgery group and combined surgery group were analyzed and compared.

ResultsThe success rate of hemostasis of uterine balloon compression(92.31%) was greater than that of uterine artery ligation(63.49%) and B-Lynch suture(61.54%) (P < 0.05).The operative time of uterine balloon compression was less than that of uterine artery ligation and B-Lynch suture(P < 0.01).There was no statistical significance in the intraoperative hemorrhage, 24-hour hemorrhage, length of stay, and 24-hour hemoglobin change among three single groups(P>0.05).The operation time, intraoperative bleeding, 24-hour total bleeding, postoperative hospital stay, blood transfusion rate, combined diffuse intravasc ular coagulation and shock in three single surgery groups were lower than those in three combined surgery group(P < 0.01).However, there was no statistical difference in the 24-hour hemoglobin change, hysterectomy, postoperative transfer to ICU, puerperal infection, lochia duration and uterine involution between two groups(P>0.05).

ConclusionsBalloon compression hemostasis has high success rate and short operation time, so it can be considered as the first choice for refractory postpartum hemorrhage.When a surgical option is not effective in hemostasis, the combined surgical protocols should be timely used, which does not increase the risk of late maternal complications.