scholarly journals Study on the application of King’s combined uterine suture for hemostasis during cesarean section

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Xia ◽  
Jinxiao Lin ◽  
Yan Dai ◽  
Xinrui Wang
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Twin Pregnancy ◽  
Placenta Previa ◽  
Breech Presentation ◽  
Lower Uterine Segment ◽  
Efficacy And Safety ◽  
Reduce Blood Loss ◽  
Normal Shape ◽  
Central Placenta Previa

Abstract Introduction Postpartum hemorrhage is a serious complication of childbirth and is still the leading cause of maternal death worldwide. Lower uterine segment hemorrhage during cesarean section is an important cause of postpartum hemorrhage. Our objective is to expore the efficacy and safety of King’s combined uterine suture for hemostasis during cesarean section. Methods We examined 48 cases: 16 cases of pernicious placenta previa (including one case of twins), 11 cases of central placenta previa (including one case of twins), 18 cases of uterine scarring (including two cases of twins), as well as one case of twin pregnancy, two cases of breech presentation, and one case of pulmonary hypertension. The “King’s combined uterine suture” method for hemostasis was used in patients with lower uterine segment hemorrhage during cesarean section. Results The results showed that all patients had successful hemostasis during surgery, and there were no cases of hysterectomy. Conclusion We have concluded that King’s combined uterine suture is a fast and safe hemostasis method for cesarean section that can effectively reduce blood loss and restore the normal shape of the lower uterine segment. Furthermore, this suture method can reduce postpartum hemorrhage and hysterectomy rate, as well as improve maternal prognosis.

scholarly journals Epidemiological, clinical, prognostic and therapeutic aspects of twin delivery in two referral maternity units in Dakar (Senegal)

2018 ◽  
Vol 7 (2) ◽  
pp. 364
Author(s):  
Omar Gassama ◽  
Magatte Mbaye ◽  
Aminata Niass ◽  
Diodio Boye ◽  
Babacar Biaye ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Twin Pregnancy ◽  
Placenta Previa ◽  
Uterine Cavity ◽  
Breech Presentation ◽  
Premature Delivery ◽  
Time Interval ◽  
Maternal Complications ◽  
Twin Delivery ◽  
Second Twin

Background: Twin pregnancy is the simultaneous development of two embryos and then two fetuses in the uterine cavity. Objective of present study was to assess the epidemiological, clinical, prognostic and therapeutic aspects of twin delivery in two referral maternity units in Dakar.Methods: A descriptive and analytical retrospective bi-centric study of all cases of twin deliveries recorded in two referral center in Dakar was conducted during the period January 1st, 2005-December 31st, 2015, i.e. an 11-year period. It concerned 619 pregnant women who gave birth to twins in these two referral medical structures. The epidemiological parameters, clinical, prognostic and therapeutic aspects of twin childbirth were studied. The data were entered and analysed using Epi info version 3.5.3.Results: The twinning prevalence was 1.11%. The majority of our parturient women (506 or 81.7% of the cases) came from the Dakar suburbs. The average age of the parturient women was 28 years and the gestity age 3.1. Pregnancy was well monitored for 98.5% of the parturient women with an average number of prenatal consultations of 3.6. The first prenatal consultation was performed in 52% of cases in the first quarter. In more than one third of cases (234 or 37.8%), the diagnosis was made in the third quarter of pregnancy. 113 cases (18.2%) of premature rupture of membranes, 10 cases (1.61%) of threat of premature delivery and 7 cases (11.13%) of placenta previa were registered. During labour, the diagnosis was made by clinical examination in 32.2% of cases. Bichorial biamniotic twin pregnancy was the most frequent anatomical type (62.6%). On admission, the first twin (T1) was in cephalic presentation in 56.7%, in breech presentation in 15.2%; The second twin (T2) was in breech presentation in 21.1% of the cases. Caesarean section was related to the first twin in 50.6% and the second twin in 53.8% of the cases. Caesarean section was performed in 50.6% for the first twin and in 53.8% for the second twin. The mean time interval between the delivery of T1 and that of T2 was 17.4 min. Low birth weight was more frequent for the second twin (54.3%). The stillbirth rate was 48.26 per thousand. Maternal complications were dominated by renal-vascular syndromes (4.2%), haemorrhagic causes (1.86%), perineal lesions (1.6%) and uterine rupture (0.97%). Postpartum haemorrhage was observed in 8 cases (1.29%). Maternal mortality was nilConclusions: Twin delivery poses varying difficulties due to the complexity of obstetrical mechanics and the frequency of dystocic presentations. Despite improved maternal prognosis, in recent years, perinatal mortality and morbidity, still high, remain a constant concern.

Buttock necrosis after hypogastric artery embolization for postpartum hemorrhage

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Robin Julve ◽  
Eva Meler ◽  
Elena Murillo ◽  
Bernat Serra
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Twin Pregnancy ◽  
Rare Complication ◽  
Skin Grafting ◽  
Hypogastric Artery ◽  
Vacuum Assisted Closure ◽  
Artery Embolization ◽  
Vacuum Assisted Closure Therapy

AbstractUterine or hypogastric artery embolization is a useful alternative to hysterectomy in the treatment of postpartum hemorrhage.Puerpera requiring a bilateral hypogastric artery embolization for postpartum hemorrhage after cesarean section in a term twin pregnancy. Unexpected unilateral buttock necrosis appeared 5 days later. Treatment consisted of debridement, the use of vacuum-assisted closure therapy and skin grafting.Buttock necrosis is a rare complication after hypogastric artery embolization in the treatment of postpartum hemorrhage.

scholarly journals Caesarean section: its rates and indications at a tertiary referral center in Eastern Nepal

1970 ◽  
Vol 9 (3) ◽  
pp. 179-183
Author(s):  
S Chhetri ◽  
U Singh
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Caesarean Section Rate ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Tertiary Referral ◽  
Common Indication ◽  
Tertiary Referral Center ◽  
Referral Center

Background: There has been a sustained increase in the rate of caesarean section in the last few years around the world. Data regarding the current caesarean rate and the trends of its indications in eastern Nepal have not been estimated earlier. Aim: To assess the rate of caesarean sections and the varying indications for caesarean section in a tertiary referral center in eastern Nepal. Methods: All hospital deliveries that took place in BPKIHS between January 2006 and December 2007 were recorded to assess the caesarean section rate and its indications. Results: A total of 5330 deliveries were conducted in 2006. Likewise the total number of deliveries conducted in 2007 was 6634. In 2006 caesarean sections were performed in 28.6% (1524) of all patients. The rate of caesarean sections in 2007 increased and was 33.7% (2239). The most common indication for caesarean section was meconiumstained liquor, which constituted 23.4% (883). The next frequent indication was previous caesarean section, which accounted for 17.2% (650), followed by breech presentation in 11.1% (417), fetal distress in 9.6% (364), non-progress of labor in 7.2% (270), cephalopelvic disproportion in 6.2% (234, and placenta previa in 4.4% (165). Conclusions: There is a increasing trend of performing cesarean section in the tertiary referral center in east era Nepal. The most common indication for cesarean section is meconium-stained liquor. Keywords: Caesarean section; caesarean delivery rates; Nepal DOI: http://dx.doi.org/10.3126/hren.v9i3.5587   HR 2011; 9(3): 179-183

scholarly journals Efficacy of prophylactic tranexamic acid administration in prevention of postpartum hemorrhage in placenta previa cesarean section: an interventional study

2021 ◽  
Vol 11 (1) ◽  
pp. 153
Author(s):  
Monika Rathore ◽  
Anjali Gupta ◽  
Nidhi Kumari
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Intravenous Infusion ◽  
Very Low Birth Weight ◽  
Placenta Previa ◽  
Skin Incision ◽  
Group 2 ◽  
Group 1

Background: Postpartum hemorrhage accounts for the major part of the mortality as well as morbidity like severe anemia, need for blood transfusion, hospital stay and infection. Aim and objectives of the study were to determine the efficacy and safety of prophylactic tranexamic acid and intravenous tranexamic acid in preventing postpartum hemorrhage in women undergoing caesarean section for placenta previa.Methods: Seventy women with placenta previa over 1 year, randomized into 2 groups: group 1 (n=35): Women who received 10 IU oxytocin intravenous infusion after placental delivery and group 2 (n=35): Women who received 1 gm (10 ml) tranexamic acid IV before skin incision plus 10 IU oxytocin intravenous infusion after placental delivery.Results: The mean age was similar in 2 groups i.e., 26.34±4.78 years in group 1 and 27.31±5.62 years in group 2. Most women in the present study presented with type IV placenta previa i.e., 34.3% in group 1 and 48.6% in group 2. Mean pre-operative hemoglobin was 9.57±1.54 g/dl in group 1 and 9.59±1.35 g/dl in group 2. Intra-operative mean blood loss was 729.31±172.45 ml in intravenous oxytocin group and 464.86±28.00 ml in intravenous tranexamic acid group. A total of 74.3% women in group 1 and 20% women in group 2 developed postpartum hemorrhage. Mean post-operative hemoglobin was 8.04±1.34 g/dl in group 1 and 8.85±1.26 g/dl in group 2. In group 1, 5.7% neonates were born with very low birth weight and while none in group 2. 51.4% neonates in group 1 and 45.7% in group 2 had low birth weight.Conclusions: It is concluded that tranexamic acid used prophylactically intravenously before skin incision in patients undergoing cesarean section for placenta previa significantly reduces intra-operative blood loss. 

scholarly journals Vertical compression sutures for control of postpartum hemorrhage from a placenta previa in cesarean section — To evaluate the usefulness of this technique

2014 ◽  
Vol 2 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Toshitaka Tanaka ◽  
Shintaro Makino ◽  
Takashi Yorifuji ◽  
Tomomi Saito ◽  
Taro Koshiishi ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Placenta Previa

Successful treatment of placenta previa totalis using the combination of a two-stage cesarean operation and uterine arteries embolization in a hybrid operating room

2016 ◽  
Vol 5 (1) ◽  
pp. 31-34
Author(s):  
Maya Koyano ◽  
Junichi Hasegawa ◽  
Tatsuya Arakaki ◽  
Ryu Matsuoka ◽  
Akihiko Sekizawa
Keyword(s):  
Cesarean Section ◽  
Operating Room ◽  
Placenta Previa ◽  
Transvaginal Ultrasound ◽  
Arterial Embolization ◽  
Lower Uterine Segment ◽  
Hybrid Operating Room ◽  
Operation Room ◽  
Hybrid Operation ◽  
Emergency Cesarean

Abstract A 37-year-old primigravida female with placenta previa totalis was transferred to our hospital at 29 weeks of gestation. A transvaginal ultrasound examination showed a dropped placenta into the uterine cervix and an effaced lower uterine segment. The boundary between the cervical muscle layer and the placenta was unclear. Consequently, although it was unclear whether complication of the adherence of placenta was present or not, massive hemorrhage with atonic bleeding in the lower uterine segment after placenta removal was strongly suspected. As the patient had uncontrolled vaginal bleeding, an emergency cesarean section was performed in a hybrid operating room. A transverse fundal incision of the uterus was made, and a 1143 g healthy neonate was delivered. As no signs of placental detachment or persistent bleeding were found, the uterus was closed, leaving the placenta. Thereafter bilateral uterine arterial embolization (UAE) with absorbable gelatin sponges was performed. On the third day after the operation, a second operation for placental removal. The placenta detached smoothly, but compression sutures were placed to control the bleeding at the site of placental removal around the uterine isthmus. In this case, we were able to conduct the treatment smoothly because of the antenatal ultrasound assessment and precise preparation of the cesarean section with UAE in the hybrid operation room. Using the hybrid operation room, sharing detailed surgical planning in cooperation with the physicians from other departments is important for obtaining a good outcome.

scholarly journals Successful management of uncontrolled postpartum hemorrhage due to morbidly adherent placenta with Resuscitative endovascular balloon occlusion of the aorta during emergency cesarean section - A case report -

2020 ◽  
Vol 15 (3) ◽  
pp. 314-318 ◽  
Author(s):  
Sung Mi Ji ◽  
Chaemin Cho ◽  
Gunhwa Choi ◽  
Jaegyok Song ◽  
Min A Kwon ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Therapeutic Option ◽  
Placenta Previa ◽  
Endovascular Embolization ◽  
Balloon Occlusion ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Emergency Cesarean ◽  
Endovascular Balloon Occlusion

Background: Morbidly adherent placenta (MAP) may cause life-threatening postpartum hemorrhage (PPH) requiring massive transfusions. Furthermore, it could endanger the lives of both mother and baby. Despite various efforts, such as adjuvant endovascular embolization and hysterectomy, massive PPH due to MAP still occurs and is difficult to overcome. Case: Herein, we described the case of a 40-year-old woman with placenta previa totalis who experienced massive bleeding during a cesarean section. We used resuscitative endovascular balloon occlusion of the aorta (REBOA) and it improved the condition of the surgical field and the hemodynamic stability of the patient temporarily. The patient was successfully managed without further complications. Conclusions: REBOA can be used as a rescue procedure for uncontrolled bleeding situations in patients with MAPs. Anesthesiologists should consider and recommend REBOA as another resuscitative therapeutic option in the case of massive PPH.

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