Zusammenfassung
Hintergrund und Fragestellung: Die postpartale Blutung ist eine der Hauptursachen für die maternale Mortalität.
Nach Versagen der medikamentösen Therapie stellt das von Pereira beschriebene uteruserhaltende
operative Vorgehen eine sinnvolle Alternative zur Hysterektomie dar.
Material und Methodik: Der Uterus wird durch mehrere oberflächlich gestochene horizontal und longitudinal
geführte Fäden komprimiert. Zusätzlich wird die uterine Durchblutung reduziert.
Ergebnisse: Fünf Frauen, die im Rahmen einer Sektio trotz medikamentöser Therapie mit Oxytocin
und Sulproston eine schwere Atonie entwickelten, wurden durch Kompressionsnähte in
Anlehnung an Pereira erfolgreich uteruserhaltend behandelt. Der postoperative Verlauf
war unkompliziert.
Schlussfolgerung: Das uteruserhaltende Verfahren mit Uteruskompressionsnähten nach Pereira ist ein
vergleichsweise einfaches und zügig durchzuführendes Verfahren zur operativen Behandlung
medikamentös refraktärer postpartaler Atonien.
Abstract
Background: Postpartum haemorrhage is an important cause of maternal mortality. After failure
of medical treatment, the application of uterine compressive sutures as described
by Pereira to treat postpartum bleeding is an alternative to hysterectomy.
Material and Methods: The uterus is compressed by multiple, superficially inserted sutures which are applied
transversally and longitudinally around the uterus. Additionally the vascular flow
is reduced.
Results: Five women underwent a Caesarean section and, in spite of treatment with oxytocin
and sulprostone developed severe postpartum haemorrhage. Compression sutures of the
uterus as described by Pereira were successful in all cases. The follow-up was uneventful
in all cases.
Conclusion: Compressive sutures of the uterus as described by Pereira are easy and quick to perform
for treating uterine atony with postpartum bleeding.
Schlüsselwörter
postpartale Blutung - Uteruskompressionsnähte - operative Therapie
Key words
postpartum haemorrhage - uterine compression suture - surgical treatment
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Dr. med. W. Stein
Zentrum für Frauenheilkunde der Georg-August-Universität Göttingen
Robert-Koch-Straße 40
37075 Göttingen
Email: werner.stein@med.uni-goettingen.de
