A Novel Tou
A Novel Tourniquet to Reduce Blood Loss during Surgical Treatment of Postpartum Hemorrhage in Cesarean Section
Abdelaziz A. Tammam1, Ahmed H. Abdellah1 and Mohamed Y. Abdel-Rahman2
Departments of Obstetrics & Gynecology, Faculty of Medicine, South Valley University, Qena1, and Faculty of Medicine Sohag University2, Egypt. firstname.lastname@example.org
Abstract:Objective: To evaluate the efficacy and safety of a novel tourniquet in the management of postpartum hemorrhage (PPH) during cesarean section. Design: Observational study Materials and Methods: This study was conducted in a tertiary university hospital between August 2010 and May 2012. Twenty one women with PPH (group 1) underwent a novel intra-cesarean tourniquet were compared to a well selected matched (21 patients) who developed PPH during cesarean section (group 2). A 16 or 18 French Foley’s catheter wasturned around the exteriorized uterus and the infundibuloplevic ligaments at the level of the uterosacral ligaments and tied 3 cm lower to the level of the CS incision. This tourniquet was applied to group 1 before attempting any surgical procedures while stepwise surgical interventions were performed in group 2 according to the hospital protocol. The outcome measures were the intra- and post-operative blood loss, need for blood transfusion, and maternal morbidities and mortalities. Fisher exact and Mann-Whitney tests were used for statistical analysis when appropriate.Results: Intra-operative blood loss and the need for blood transfusion were significantly lower in group 1 compared to group 2 (P< 0.01). No significant difference between the two groups regarding pre- and post-operative hemoglobin or hematocrite value. Group 2 showed more frequent pyrexia (19% Vs 14%) and wound gapping (19% Vs 9%), however these differences were not significant (P = 0.50 and 0.33 respectively). No incidence of urinary injury in both groups. Cesarean hysterectomy wasindicated in 10 patients; 5 in each group. One case of maternal mortality and another case with lower limb deep venous thrombosis were recorded in group 2. Conclusion: This technique is an effective and safe intervention for controlling postpartum hemorrhage during cesarean section. It may be offered as a preliminary step to prevent massive bleeding and allow time for blood transfusion and further procedures.
[Abdelaziz A. Tammam, Ahmed H. Abdellah and Mohamed Y. Abdel-Rahman. A Novel Tourniquet to Reduce Blood Loss during Surgical Treatment of Postpartum Hemorrhage in Cesarean Section. J Am Sci 2012;8(10):100-103]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 15
Key words: postpartum hemorrhage, Tourniquet, Cesarean Section