Uterine incision and maternal blood loss in preterm caesarean section

1993 ◽  
Vol 252 (3) ◽  
pp. 113-117 ◽  
Author(s):  
T. T. Lao ◽  
S. H. Halpern ◽  
E. T. Crosby ◽  
C. Huh
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Maternal Blood ◽  
Uterine Incision

scholarly journals Comparative study to identify the safety, effectiveness and ease of obstetric forceps for delivery of floating head in cesarean section

2018 ◽  
Vol 7 (5) ◽  
pp. 1760 ◽  
Author(s):  
Sonali Jitendra Ingole ◽  
Saloni Manwani
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Apgar Score ◽  
Uterine Artery ◽  
Fetal Head ◽  
Uterine Incision ◽  
Assisted Delivery ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: Difficulty is frequently encountered in extraction of floating fetal head. This study will focus on comparison of Forceps assisted fetal head extraction during Lower segment caesarean section (LSCS) with manual method of extraction in LSCS.Methods: The ANC patients attending antenatal OPD and admitted for elective caesarean section fulfilling the inclusion criteria were randomly divided into two groups each of 400 patients: Group 1 of patients undergoing manual extraction of fetal head during LSCS; and Group 2 consisting of patients with forceps assisted delivery of fetal head in LSCS. Following factors will be evaluated in patients: maternal blood loss, any extension of uterine incision, difference in pre and post op hemoglobin levels of the patient and Apgar score of baby at 1 and 5 minutes.Results: Patients in both the groups were matched demographically. The demographic variables such as maternal age, weight, parity and MGA (Mean Gestational age) were comparable in both the groups. Blood loss was significant in Group 1 (manual delivery) as compared with Forceps assisted delivery. This is also reflected in difference in pre and post op Hemoglobin levels. Although baby outcome in terms of Apgar score was similar in both groups, however morbidity in terms of uterine artery trauma, extension of uterine incision was much less in group 2 (Forceps assisted LSCS delivery)Conclusions: Although there was no statistically significant difference in outcome of babies (APGAR score), complication(s) were less (blood loss, uterine artery trauma) in Forceps assisted LSCS delivery group. Proper selection of patient(s), early anticipation for application for Forceps can help for better outcome of caesarean delivery.

scholarly journals Effectiveness of ligation of uterine vessels prior to uterine incision for major placenta previa on reducing maternal morbidity without increasing neonatal morbidity

2018 ◽  
Vol 7 (7) ◽  
pp. 2891
Author(s):  
Shantha V. K. ◽  
Priyadarshini M. ◽  
Priya Dharshini A. ◽  
Litty Mariyam Jacob
Keyword(s):  
Caesarean Section ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Control Group ◽  
Mild Depression ◽  
Uterine Incision ◽  
The Mean ◽  
Uterine Vessels

Background: Placenta previa causes massive obstetric haemorrhage and severe maternal morbidity. The objective is to analyse the effectiveness of uterine vessels (artery and vein) ligation before uterine incision in reducing blood loss and hysterectomy during caesarean section for major placenta previa without increasing morbidity in the newborn.Methods: A retrospective analysis of caesarean section for major placenta previa from 2002 to 2017 was done.  Uterine vessels ligation before uterine incision was done in 52 patients. In 19 patients unilateral and in 33 patients bilateral uterine vessels ligation was done before uterine incision. In control group, 12 patients with major placenta previa uterine vessels were ligated after the removal of the placenta. The blood loss, blood transfusion, maternal morbidity and NICU admission of the newborns were compared.Results: The mean blood loss was 1002 ml in unilateral, 793 ml in bilateral uterine vessels ligation group, compared to 2191 ml in the control group. The mean blood transfusion volume 0.89 units in unilateral 0.60 units in bilateral ligation group while 2.33 units in the control group. The difference in blood loss and blood transfusion were statistically significant. Out of 52 babies, only 6 babies were admitted in NICU for mild depression with stay less than 3 days.Conclusions: Uterine vessels ligation before uterine incision reduces blood loss and hysterectomy during caesarean section for placenta previa without increasing the morbidity in the newborns.

Effect of expansion technique of uterine incision on maternal blood loss in cesarean section

2009 ◽  
Vol 282 (5) ◽  
pp. 475-479 ◽  
Author(s):  
Leila Sekhavat ◽  
Razieh Dehghani Firouzabadi ◽  
Parisa Mojiri
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Maternal Blood ◽  
Uterine Incision ◽  
Expansion Technique

scholarly journals Higher Incision at Upper Part of Lower Segment Caesarean Section

2014 ◽  
Vol 52 (194) ◽  
pp. 764-770 ◽  
Author(s):  
Yong Shao ◽  
Meena Pradhan
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Operation Time ◽  
Suture Line ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Uterine Incision ◽  
Segment Versus ◽  
Incision Technique ◽  
Duration Of Operation

Introduction: To determine if the upper part of the lower segment of the uterus is a better site for cesarean incision then the traditionally used lower end. Methods: This is a case-control study (1:1 ratio) conducted from 1st October 2012– 30th September 2013 observed between transverse incision at the upper part of the lower segment versus traditional lower segment of the uterus. Two hundred caesarean sections were performed via a transverse uterine incision at the upper part of the lower segment and equal numbers of uterine incision was performed at traditional lower segment. To obtain less intraoperative bleeding high incision made at thicker wider muscular part at of the upper part of lower segment about 2-3 cm distances from vesico-uterine serosa. Results: The estimated volume of blood loss in high incision 188±60.1 ml was significantly less compared to traditional incision 330.1± 86.5 ml (p<0.05). Duration of operation 30.5± 6.6 minute versus 45.3±7.2 minute and tearing the uterine incision was significantly less with the high incision versus traditional incision. Other procedural and patient benefits are noted. Conclusions: An incision at the upper part of the lower segment reduces blood loss, enhances uterine retraction, predisposes to fewer complications, is easier to repair, precludes bladder adhesion to the suture line and reduces operation time.  Keywords: caesarean section; higher incision technique; traditional uterine incision technique. 

scholarly journals Placenta accreta spectrum disorders—experience of management in a German tertiary perinatal centre

2020 ◽  
Author(s):  
Anja Bluth ◽  
Axel Schindelhauer ◽  
Katharina Nitzsche ◽  
Pauline Wimberger ◽  
Cahit Birdir
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Placenta Accreta ◽  
Caesarean Section Rate ◽  
Management Strategies ◽  
Management Approach ◽  
Optimal Setting ◽  
Placenta Accreta Spectrum ◽  
Management Approaches

Abstract Purpose Placenta accreta spectrum (PAS) disorders can cause major intrapartum haemorrhage. The optimal management approach is not yet defined. We analysed available cases from a tertiary perinatal centre to compare the outcome of different individual management strategies. Methods A monocentric retrospective analysis was performed in patients with clinically confirmed diagnosis of PAS between 07/2012 and 12/2019. Electronic patient and ultrasound databases were examined for perinatal findings, peripartum morbidity including blood loss and management approaches such as (1) vaginal delivery and curettage, (2) caesarean section with placental removal versus left in situ and (3) planned, immediate or delayed hysterectomy. Results 46 cases were identified with an incidence of 2.49 per 1000 births. Median diagnosis of placenta accreta (56%), increta (39%) or percreta (4%) was made in 35 weeks of gestation. Prenatal detection rate was 33% for all cases and 78% for placenta increta. 33% showed an association with placenta praevia, 41% with previous caesarean section and 52% with previous curettage. Caesarean section rate was 65% and hysterectomy rate 39%. In 9% of the cases, the placenta primarily remained in situ. 54% of patients required blood transfusion. Blood loss did not differ between cases with versus without prenatal diagnosis (p = 0.327). In known cases, an attempt to remove the placenta did not show impact on blood loss (p = 0.417). Conclusion PAS should be managed in an optimal setting and with a well-coordinated team. Experience with different approaches should be proven in prospective multicentre studies to prepare recommendations for expected and unexpected need for management.

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