The Impact of Mechanical Methods on the Postpartum Haemorrhage Prophylaxis During Caesarean Section
Study Details
Study Description
Brief Summary
The rate of heavy blood loss is higher in Cesarean delivery compared to vaginal deliveries. Since postpartum hemorrhage is a life threatening situation to decrease the maternal mortality and morbidity rates, precautions should be taken. In this study, we aim to decrease the amount of postpartum hemorrhage by clamping the uterine artery after the delivery of the baby during Cesarean delivery.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Obstetrical hemorrhage, is the most common cause of maternal mortality and morbidity that could be prevented. It can appear at early and late stage of delivery and after delivery. It Is defined as loss of more than 500 mL of blood in vaginal deliveries, whereas more than 1L of blood during C-section. The rate of heavy blood loss is higher in Cesarean delivery compared to vaginal deliveries. The incidence of postpartum anemia in Europe is 50% while in developing countries like Turkey it rises up to 50-80%. Since postpartum hemorrhage is a life threatening situation to decrease the maternal mortality and morbidity rates, precautions should be taken. To preserve the hemoglobin concentrations and hemostasis and to optimize the patient's results, evidence-based methods should be performed. Given these circumstances, interventions using pharmacological, mechanical and surgical methods are necessary to minimize the blood loss. Uteroronics are the first line treatment options followed by fundal massage, controlled traction of cord and delivery of placenta, bimanual compression, intrauterine hydrostatic balloon. After these interventions, surgical interventions such as compression sutures, bilateral uterine artery ligation, hysterectomy and pelvic tamponade could be performed. In this study, we aim to decrease the amount of preoperative part of postpartum hemorrhage by clamping the uterine artery by Darmklemmen clamp after the delivery of the baby before the delivery of placenta during Cesarean delivery.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Clamp In these patients, we clamped the uterine artery by Darmklemmen clamp after the delivery of the baby before the delivery of placenta. We released the clamp after the suturing of the uterus is finished. |
Procedure: Clamping the uterine artery bilaterally during Cesarean section
We clamped the uterine artery by Darmklemmen clamp, which grasps the tissue delicately without damage, after the delivery of the baby before the delivery of placenta. The clamp is released after the suturing of Munro-Kerr incision is finished, before bleeding control. The duration of clamping time is recorded.
|
| No Intervention: Control Routine Cesarean section is done. |
Outcome Measures
Primary Outcome Measures
- The rate of blood loss [during C-section]
by measuring the suction
- The rate of blood loss [during C-section]
by weighting the gauze used during C-section after subtracting the tare
- The rate of blood loss [24 hours]
by comparing the preoperative and postoperative hemoglobin values
Eligibility Criteria
Criteria
Inclusion Criteria:
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Women gave birth >37 GW
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singleton pregnancy
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with normal fetal development
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Not emergency C-section
Exclusion Criteria:
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C/sections with indications of plasenta prevue or placenta acrreta spectrum
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with amniotic fluid abnormalities
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multiple pregnancies
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threatened preterm labor
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who have preeclampsia or other type of obstetrical complications
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Istanbul University-Cerrahpasa | Istanbul | Turkey | 34098 |
Sponsors and Collaborators
- Istanbul University - Cerrahpasa (IUC)
Investigators
- Study Director: Ismail Cepni, Prof, Istanbul University - Cerrahpasa (IUC)
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 37612