Influence of Blunt Versus Sharp Expansion of Uterine Incision on Degree of Intraoperative Blood Loss at Caesarean Section

Abstract Background: It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy. Methods: A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed. Results: No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value=0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value=0.18), and postoperative fever (4% vs 8.33%, p value=0.6). Conclusion: Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy. Trial registration: NCT03009812 at clinicaltrials.gov, registered January 2017

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Uterine incision and maternal blood loss in preterm caesarean section

Archives of Gynecology and Obstetrics ◽

10.1007/bf02456674 ◽

1993 ◽

Vol 252 (3) ◽

pp. 113-117 ◽

Cited By ~ 26

Author(s):

T. T. Lao ◽

S. H. Halpern ◽

E. T. Crosby ◽

C. Huh

Keyword(s):

Caesarean Section ◽

Blood Loss ◽

Maternal Blood ◽

Uterine Incision

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Blood loss from transverse versus longitudinal uterine incision in abdominal myomectomy: a randomized controlled trial

BMC Women s Health ◽

10.1186/s12905-020-01113-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Alaa Elguindy ◽

Hosam Hemeda ◽

Mohamed Esmat Shawky ◽

Mohamed Elsenity ◽

Medhat Adel Elsayed ◽

...

Keyword(s):

Blood Loss ◽

Operative Time ◽

Controlled Trial ◽

Intraoperative Blood Loss ◽

Postoperative Fever ◽

Longitudinal Incision ◽

Abdominal Myomectomy ◽

Randomized Controlled ◽

Uterine Incision ◽

Significant Difference

Abstract Background It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy. Methods A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed. Results No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value = 0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value = 0.18), and postoperative fever (4% vs 8.33%, p value = 0.6). Conclusion Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy. Trial registration: NCT03009812 at clinicaltrials.gov, registered January 2017

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Blood Loss from Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled Trial

10.21203/rs.2.9943/v4 ◽

2020 ◽

Author(s):

Alaa Elguindy ◽

Hosam Hemeda ◽

Mohamed Esmat Shawky ◽

Mohamed Elsenity ◽

Medhat Adel Elsayed ◽

...

Keyword(s):

Blood Loss ◽

Operative Time ◽

P Value ◽

Intraoperative Blood Loss ◽

Postoperative Fever ◽

Longitudinal Incision ◽

Abdominal Myomectomy ◽

Randomized Controlled ◽

Uterine Incision ◽

Significant Difference

Abstract Background: It is unclear whether transverse uterine incision is non-inferior to longitudinal incision during myomectomy with regard to bleeding. Our aim was to compare between transverse and longitudinal uterine incisions in myomectomy.Methods: A parallel randomized controlled single-blinded study in a university affiliated hospital, in the period between January 2017 and April 2018, in which 52 women candidates for abdominal myomectomy were randomized into transverse uterine incision or longitudinal uterine incision groups (26 in each group). Intraoperative blood loss (estimated directly by blood volume in suction bottle and linen towels and indirectly by difference between preoperative and postoperative hematocrit), operative time and postoperative fever were analyzed.Results: No statistically significant difference was found between transverse and longitudinal incisions regarding intraoperative blood loss (389.7 ± 98.56 ml vs 485.04 ± 230.6 ml respectively, p value=0.07), operative time (59.96 ± 16.78 min vs 66.58 ± 17.33 min respectively, p value=0.18), and postoperative fever (4% vs 8.33%, p value=0.6).Conclusion: Transverse uterine incision does not cause more blood loss than longitudinal incision and is a reasonable option during abdominal myomectomy.Trial registration: NCT03009812 at clinicaltrials.gov, registered January 2017

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Discussion on the Timing of Balloon Occlusion of the Abdominal Aorta during a Caesarean Section in Patients with Pernicious Placenta Previa Complicated with Placenta Accreta

BioMed Research International ◽

10.1155/2017/8604849 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Baoju Zhu ◽

Kaili Yang ◽

Lina Cai

Keyword(s):

Caesarean Section ◽

Blood Loss ◽

Abdominal Aorta ◽

Placenta Accreta ◽

Placenta Previa ◽

Balloon Occlusion ◽

Intraoperative Blood Loss ◽

Transverse Incision ◽

Aortic Balloon Occlusion ◽

Group B

Objective. This paper is aimed at investigating the role and value of the timing of balloon occlusion of the abdominal aorta during caesarean section in patients with pernicious placenta previa complicated with placenta accreta. Methods. 79 cases admitted to the Second Affiliated Hospital of Zhengzhou University from September 2015 to December 2016 were treated with ultrasound mediated abdominal aortic balloon occlusion. Among them, 42 cases, whose balloon occlusion time was selected before the delivery and transverse incision was taken, were group A. The other 37 cases were group B, whose timing of balloon occlusion was selected after the delivery and the uterine incision made trying to avoid the placenta or double incisions. The intraoperative blood loss, utilization of blood, and other indicators were compared between the two groups. Results. The intraoperative blood loss in groups A and B was 413.8 ± 105.9 ml and 810.3 ± 180.3 ml, and the utilization of blood products in groups A and B was 30.23% and 89.2%. The total hysterectomy rate was 2.53% (2/79), with no hysterectomies in groups A and 2 cases in group B. Conclusion. The balloon occlusion of the abdominal aorta before the delivery combined with a transverse incision is more effective.

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Analysis of safety of performing simultaneous myomectomy in caesarean section

Medical alphabet ◽

10.33667/2078-5631-2020-16-58-60 ◽

2020 ◽

pp. 58-60

Author(s):

I. N. Medvedeva ◽

K. A. Nozdracheva ◽

A. D. Khizhnyak

Keyword(s):

Caesarean Section ◽

Blood Loss ◽

Retrospective Analysis ◽

Safety Assessment ◽

Average Duration ◽

Average Length ◽

Uterine Myoma ◽

Intraoperative Blood Loss ◽

Post Operative Period ◽

Length Of Hospitalization

The purpose of the study. Safety assessment for expansion of caesarean section to myomectomy. Materials and techniques. A retrospective analysis was conducted of the birth histories of 44 patients with uterine myoma with extension of caesarean section to myomectomy. Results. The average duration of the operation was 54.3 ± 23.7 minutes. Significant inversive complications were not registered. Average blood loss amounted to 661.4 ± 193.2 ml, that does not exceed the generally accepted blood loss limits of standard caesarean section surgery. Post-operative period was without features. The average length of hospitalization was 7.0 ± 1.5 days. Conclusion. Expansion of the operation caesarean section to myomectomy does not significantly affect intraoperative blood loss, post-operative haemoglobin and hematocrit of the blood, provided there were no reductions in these rates before operation. Hospitalization time does not increase significantly. The post-operative period primarily runs without complications.

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The effect of oxytocin dosage on the amount of intraoperative blood loss during caesarean section

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2018-6-51-56 ◽

2018 ◽

Vol 17 (6) ◽

pp. 51-56

Author(s):

E.N. Degtyaryev ◽

◽

E.M. Shifman ◽

G.P. Tikhova ◽

А.V. Kulikov ◽

...

Keyword(s):

Caesarean Section ◽

Blood Loss ◽

Intraoperative Blood Loss

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181575 ◽

2018 ◽

Vol 7 (5) ◽

pp. 1760 ◽

Cited By ~ 1

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.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182902 ◽

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.

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