Analysis Of The Reason Of Uterine Corn Inertia And The Effect Of Arcuate Artery Suture Hemostasis During Cesarean Section

Objective To analyse the reason of uterine corn inertia and discuss the effect ofarcuate artery suture hemostasis during cesarean section．Methods To collect the patients in No.202People’s Liberation Army Hospitalswith uterine corn inertia during cesarean section in September2013to December2013，who failed to respond to conservative management，a total of50cases．To analyse thereason of uterine corn inertia from general situation，including age， gestational age，gravida， para， past medical history， history of uterine surgery， pregnancycomplications，birth weight and the condition durning operation．According to thecondition durning operation， There were24cases with unlateral uterine corninertia(group A)，the other26cases were mainly with unilateral uterine corn inertiabeside corpus uteri inertia(group B)．The patients of group A who bleeded more duingto uterine corn inertia were treated by unilateral arcuate artery suture hemostasis，patients who bleeded less in group A were threated with preventive unilateraltransfixion．Duing to group B conbined corpus uteri inertia，patients who bleededmore were threated with bilateral arcuate artery suture hemostasis， patients whobleeded less in group B were threated with preventive bilateral transfixion．If therewould be still bleeding tendency， the other operation hemostasis were used．Amongthe two groups，which received arcuate artery suture hemostasis for hemorrhage wasdefined bleeding group，which received preventive hemostasis was defined prevention group．We have made statistics of operation time， prompt hemostatic rate，bleedingvolume， effect rate，24hours bleeding volume after operation， postoperativemorbidity， postoperative complications and postoperative averaged length of day ofbleeding group in group Aand group B，also made statistics of operation time，bleedingvolume，24hours bleeding volume after operation， postoperative morbidity，postoperative complications and postoperative averaged length of day in bleeding groupand prevention group．Results：1．Among50cases，29cases with placenta attached the uterine corn(including9cases of adherent placenta，1case of succenturiate placenta），6cases oftwin pregnancy，10cases of macrosomia delivery，5cases of having history of uterinesurgery (1case of hysteromyomectomy，4cases of cesarean section)，30cases with ahistory of abortion，1case of uterine malformation (uterus didelphys)，1case ofpregnancy associated with hysteromyoma，1case of prolonged labor，3patients withhypertension disorders complicating pregnancy，8patients were old mothers．2. There were24cases of unlateral uterine corn inertia(group A) and26caseswere mainly with unilateral uterine corn inertia beside corpus uteri inertia(group B)．InGroup A，12cases were hemorrhage．16cases were hemorrhage，in Group B．Thecases with hemorrhage in group A and group B were treated by unilateral(bilateral)arcuate artery suture hemostasis． The prompt hemostatic rate of the two group was100%(12/12) and87.5%(14/16)， effect rate was100%(12/12) and100%(16/16)．Operation time was (65±4)min and (72±5)min，Bleeding volume was (535±87)ml and(643±245) ml，respectively．Among the prevention group and bleeding group，operation time was (59±7)min and (69±6) min，Bleeding volume was (212±19)ml and(596±198)ml，respectively．50cases have achieved the purpose of clinical hemostaticand had no hysterectomy．3． Among the bleeding group in group A and group B．24hours bleedingvolume after operation was (130±13)ml and (130±23) ml．postoperative morbidity was8.3%(1/12) and6.2%(1/16)，postoperative averaged length of day was (5.4±0.5)days and (5.7±0.6)days．respectively．Among Prevention group and Bleeding group，24hours bleeding volume after operation was respectively (116±11) ml and (130±19)ml，postoperative morbidity was respectively0(0/22) and7.1%(2/28)， postoperativeaveraged length of day was respectively (5.0±0.3) days and (5.6±0.6) days，respectively． There were no hemorrhage， intestinal obstruction and othercomplications happening．Conclusion:1．the main reasons of uterine corn inertia during cesarean section contain:placenta attached the uterine corn， twin pregnancy and macrosomia delivery， historyof uterine surgery，a history of abortion，uterine malformation，pregnancy associatedwith hysteromyoma，prolonged labor，hypertension disorders complicating pregnancy，old mothers，partial myometrium dysplasia，etc．2．The unilateral(bilateral) arcuate artery suture hemostasis can prevent bleedingeffectively，also effectively control the bleeding due to uterine corn inertia duringcaesarean section，it is simple， rapid， effective． having no intestinal obstruction，The blood flow and function of ovary and uterine is not affected after the surgery．...