著者
Takashi Yorifuji Jun Takeda Shintaro Makino Toshitaka Tanaka Atsuo Itakura Satoru Takeda
出版者
Japan Society for the Study of Hypertension in Pregnancy
雑誌
Hypertension Research in Pregnancy (ISSN:21875987)
巻号頁・発行日
pp.HRP2018-001, (Released:2018-07-31)
参考文献数
24
被引用文献数
6

Aim: Several devices are used for balloon tamponade. In Japan, metreurynters are widely used for cervical ripening; however, there is little evidence for their use in hemostatic uterine balloon tamponade. This study aimed to assess the non-inferiority of metreurynters as the balloon device for obstetric hemorrhage.Methods: Medical charts of all patients with obstetric hemorrhage of more than 1,000 ml who underwent balloon tamponade with metreurynters were retrospectively reviewed for five years at a tertiary referral university hospital.Results: A total of 89 uterine balloon tamponade cases were identified from medical records. Of these, 66 cases involved term postpartum hemorrhage (PPH) within 24 h after delivery (PPH group) and 23 involved other types of cases (other group), including cesarean scar pregnancy, cervical pregnancy, retained placenta, and others. In the PPH group, the average hemostasis rate was 93.9%, whereas the rate was 91.3% in the other group. Seven cases failed to achieve hemostasis with balloon tamponade only and required additional treatment. There were no adverse events related to balloon tamponade using metreurynters.Conclusions: Metreurynters used for balloon tamponade were non-inferior to Bakri balloons in hemostasis and complication rates, suggesting they are effective and appropriate for the management of obstetrical hemorrhage.
著者
Satoru Takeda Jun Takeda Taro Koshiishi Shintaro Makino Katsuyuki Kinoshita
出版者
日本妊娠高血圧学会
雑誌
Hypertension Research in Pregnancy (ISSN:21875987)
巻号頁・発行日
vol.2, no.2, pp.65-71, 2014 (Released:2015-02-06)
参考文献数
17
被引用文献数
9

The precise reporting of fetal station is important in the decision-making regarding whether instrumental vaginal delivery or cesarean section should be performed. However, accurate evaluation of fetal station is difficult because it is defined on the basis of a hypothetical vertical midline to the ischial spines. Moreover, during delivery, the fetal head descends anteriorly into the pelvis along the pelvic axis and not in the vertical direction. DeLee’s concept of fetal station, first reported in 1924, has been revised by taking into account the fetal head descent along the pelvic axis, and this concept has been in clinical use at the University of Tokyo Hospital since the 1970s.In this review, we assess the problems associated with conventional fetal station and explain the new concept of fetal station based on the trapezoidal plane and assessment of head descent upon instrumental delivery.