Management of bleeding from morbidly adherent placenta during elective repeat caesarean section: retrospective -record -based study.

ABSTRACT: BACKGROUND:Controlling massive haemorrhage from morbidly adherent placenta (MAP) at caesarean section is a major surgical challenge to obstetricians. This study compares different intra-operative interventions to control haemorrhage from morbidly adherent placenta and its impact on maternal morbidity. METHODS:Retrospective analysis was done for baseline characteristics, intra-operative and postoperative complications of 125 patients with morbidly adherent placenta who had elective CS at 35-38?weeks gestation in the period from 01/2012 to 01/2017. The included patients were categorized into three groups according to intra-operative interventions they had for controlling bleeding; Group A (n?=?42) had only balloon tamponade, Group B (n?=?40) had balloon tamponade and bilateral uterine artery ligation, in Group C (n?=?43) all cases were managed by bilateral uterine artery ligation and inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment using the cervix as a natural tamponade. RESULTS:There were no differences of baseline characteristics of patients in all groups. Group C had significantly better outcomes as compared with groups A and B; less total blood loss (Group C 2869.5?ml vs Group B 4580?ml, Group A 4812?ml, P?

SUBMITTER: El Gelany S 

PROVIDER: S-EPMC6439998 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature