scholarly journals Intraoperative bleeding control during cesarean delivery of complete placenta previa with transient occlusion of uterine arteries

2015 ◽  
Vol 58 (6) ◽  
pp. 522 ◽  
Author(s):  
Ju Hyun Kim ◽  
Eun-Ju Joung ◽  
Soo-Jung Lee ◽  
Jae Young Kwack ◽  
Yong Soon Kwon
Keyword(s):  
Cesarean Delivery ◽  
Placenta Previa ◽  
Bleeding Control ◽  
Intraoperative Bleeding ◽  
Uterine Arteries

scholarly journals Placenta previa with posterior extrauterine adhesion: clinical features and management practice

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshikazu Nagase ◽  
Shinya Matsuzaki ◽  
Masayuki Endo ◽  
Takeya Hara ◽  
Aiko Okada ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Loss ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Multivariate Regression ◽  
Placenta Previa ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding

Abstract Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P < 0.01], respectively). After propensity score matching (n = 72), intraoperative blood loss was significantly higher in the PEUA group (n = 24) than in the control group (n = 48) (1515 mL versus 870 mL, P < 0.01). Multivariate regression analysis revealed that PEUA was a significant risk factor for intraoperative bleeding before changes were implemented in practice (t = 2.46, P = 0.02). Intraoperative blood loss in the post group was successfully reduced, as opposed to in the pre group (1180 mL versus 1827 mL, P = 0.04). Conclusions PEUA was associated with total placenta previa, posterior placenta, and increased intraoperative bleeding in patients with placenta previa. Our altered management could reduce the intraoperative blood loss.

Effect of Continued Administration of Low-dose Aspirin for Intraoperative Bleeding Control in Gastric Endoscopic Submucosal Dissection

Digestion ◽  
2018 ◽  
Vol 100 (2) ◽  
pp. 139-146 ◽  
Author(s):  
Yohei Horikawa ◽  
Hiroya Mizutamari ◽  
Nobuya Mimori ◽  
Yuhei Kato ◽  
Masayuki Sawaguchi ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Low Dose ◽  
Bleeding Control ◽  
Intraoperative Bleeding ◽  
Submucosal Dissection ◽  
Dose Aspirin ◽  
Low Dose Aspirin

scholarly journals Anesthetic management in cesarean delivery of women with placenta previa: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dazhi Fan ◽  
Jiaming Rao ◽  
Dongxin Lin ◽  
Huishan Zhang ◽  
Zixing Zhou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Transfusion ◽  
Blood Loss ◽  
General Anesthesia ◽  
Cesarean Delivery ◽  
Retrospective Cohort ◽  
Placenta Previa ◽  
Neuraxial Anesthesia ◽  
Estimated Blood Loss ◽  
Maternal And Neonatal Outcomes

Abstract Background The incidence of placenta preiva is rising. Cesarean delivery is identified as the only safe and appropriate mode of delivery for pregnancies with placenta previa. Anesthesia is important during the cesarean delivery. The aim of this study is to assess maternal and neonatal outcomes of patients with placenta previa managed with neuraxial anesthesia as compared to those who underwent general anesthesia during cesarean delivery. Methods A retrospective cohort study was performed of all patients with placenta preiva at our large academic institution from January 1, 2014 to June 30, 2019. Patients were managed neuraxial anesthesia and general anesthesia during cesarean delivery. Results We identified 1234 patients with placenta previa who underwent cesarean delivery at our institution. Neuraxial anesthesia was performed in 737 (59.7%), and general anesthesia was completed in 497 (40.3%) patients. The mean estimated blood loss at neuraxial anesthesia of 558.96 ± 42.77 ml were significantly lower than the estimated blood loss at general anesthesia of 1952.51 ± 180 ml (p < 0.001). One hundred and forty-six of 737 (19.8%) patients required blood transfusion at neuraxial anesthesia, whereas 381 out of 497 (76.7%) patients required blood transfusion at general anesthesia. The rate neonatal asphyxia and admission to NICU at neuraxial anesthesia was significantly lower than general anesthesia (2.7% vs. 19.5 and 18.2% vs. 44.1%, respectively). After adjusting confounding factors, blood loss was less, Apgar score at 1- and 5-min were higher, and the rate of blood transfusion, neonatal asphyxia, and admission to NICU were lower in the neuraxial group. Conclusions Our data demonstrated that neuraxial anesthesia is associated with better maternal and neonatal outcomes during cesarean delivery in women with placenta previa.

Safety of subarachnoid block for elective cesarean delivery in women with major degree placenta previa

2016 ◽  
Vol 18 (2) ◽  
pp. 68
Author(s):  
BasseyE Edem ◽  
AjenS Anzaku ◽  
StephenD Ngwan ◽  
MichaelE Efu ◽  
AdaJ Opita
Keyword(s):  
Cesarean Delivery ◽  
Placenta Previa ◽  
Elective Cesarean Delivery ◽  
Subarachnoid Block ◽  
Elective Cesarean

scholarly journals Fahmy's four quadrant sutures: a new technique for control of blood loss during cesarean delivery for placenta previa

2018 ◽  
Vol 7 (8) ◽  
pp. 3004
Author(s):  
Mohamed S. Fahmy ◽  
Laila Ezzat ◽  
Maraey M. Khalil ◽  
Ahmed H. Elsayed ◽  
Sherif S. Fahmy ◽  
...  
Keyword(s):  
Blood Loss ◽  
Cesarean Delivery ◽  
Simple Procedure ◽  
Placenta Previa ◽  
Suture Technique ◽  
University Hospital ◽  
New Technique ◽  
Artery Ligation ◽  
The Mean ◽  
Four Quadrant

Background: The objective of this study is to assess the efficacy and safety of Fahmy's four quadrant suture technique (FFQS) in controlling blood loss during cesarean delivery for placenta previa (PP).Methods: The study was carried out in a tertiary University Hospital between January 2017 to December 2017 involved 12 women with heavy bleeding occurred after removal of the placenta from the lower section during cesarean delivery for PP. The FFQS technique consisted of two sutures to ligate the uterine branches on both sides and two sutures on the anterior and posterior wall of the lower uterine segment. Details regarding the management and maternal outcomes were recorded.Results: The mean age of the study participants was 29.58±5.29 years and the mean parity was 2.25±1.14. The mean gestational age at termination of pregnancy was 36.91±1.38 weeks.  The mean duration of the whole surgery was 78.75±43.28 minutes, while the mean duration of FFQS technique was only 10±2.09 minutes. The technique was exclusively effective in 8 out of 12 cases (66.67%) while 2 cases needed bilateral internal iliac artery ligation and 2 cases needed hysterectomy. The mean amount of blood loss in all cases was 2433.33±833.76 ml. the mean amount of transfused packed RBCs was 3.92±1.68 units and fresh frozen plasma (FFP) was 3.42±1.44 units. All cases had uneventful postoperative course and no mortality cases in present series.Conclusions: The new technique; FFQS represents a rapid, effective, and inexpensive opportunity for women with bleeding from the lower segment of uterus due to PP. This simple procedure should be attempted before other complex measures to achieve good hemostasis.

Bakri balloon during cesarean delivery for placenta previa

2013 ◽  
Vol 124 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Michael M. Beckmann ◽  
Jacqueline Chaplin
Keyword(s):  
Cesarean Delivery ◽  
Placenta Previa ◽  
Bakri Balloon
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