Alalfy modified cervical inversion technique as a tamponade in controlling PPH in placenta previa, a multicentric double blind randomized controlled trial

Alalfy, Mahmoud; Hussein, Elham T.; Saber, Waled; El-Sharkawy, Mohamed; Salama, Sameh; Lasheen, Yossra; Elshafey, Doaa; Taher, Ayman; Farouk, Dalia; Eltaieb, E; Elsirgany, Sherif; Hussein, Mohamed; Fikry, Mohamed; Hassan, Heba A.; Sadek, J; Alaa, Doaa; Torad, Hesham; Abdella, Rana; Ali, Sief El-Eslam A.; Ahmed, Yehia; Lotfy, Rehab; Hanafy, Amal; Hassan, Ahmed

doi:10.1080/14767058.2019.1678140

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…In a recent study done by Mahmoud Alalfy and his colleagues, who applied the Alalfy modified cervical inversion technique as a tamponade, his study was actually conducted among a total of 240 pregnant women with placenta previa (120 subjected to the Alalfy modified cervical inversion technique plus hemostatic sutures and another 120 who were not subjected to cervical inversion and only subjected to hemostatic sutures at Suez Canal University Hospital, Kasr Alainy Hospital and Ain Shams University Hospital) [8].…”

Section: Discussionmentioning

confidence: 99%

“…A decrease in cervix length is related to greater bacterial ascent into the lower pole of the uterus, with simultaneous reaction of maternal and/or fetal origin and the release of inflammatory mediators as indicated above, resulting in preterm parturition [6]. The cervical inversion technique's efficacy and safety have been demonstrated at several obstetrics and gynaecology centers, including Zahedan University of medical sciences and health services in Zahedan, Iran (Sakhavar N et al, 2015), and Suez Canal University Hospital's Department of Obstetrics and Gynecology [7] , [8] and done at Minia University Maternity Hospital, Egypt [9]. This study was conducted for short-term evaluation of "using the cervix as a natural tamponade to control bleeding caused by placenta accrete" on the morphology of the cervix, cervical length, cervical canal diameter, menstrual irregularity and 2ry postpartum hemorrhage.…”

Section: Short Term Follow Up For Morphological Cervical Changes In C...mentioning

confidence: 99%

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Short term follow up for morphological cervical changes in cases of placenta accreta managed by cervical advancement as a natural tamponade

Mousa

Abdelhamid

Yassien

et al. 2022

Minia Journal of Medical Research

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Background: Death as a result of pregnancy remains the chief cause of premature mortality worldwide. Placenta accreta spectrum (PAS) disorders have become a significant lifethreatening obstetrical issue due to their increased incidence. Placenta accreta and placenta previa are considered important causes of PPH. In 2007, Dawlatly and his colleagues described for the first time a simple technique of suturing an inverted lip of the cervix over the bleeding placental bed that was successful in controlling the bleeding and saving the patient's life. Our study was conducted to evaluate the impact of the cervical technique and discuss cervical changes after short-term follow-up of cases who were managed by this technique. Methods: Our study was conducted among a total of 140 pregnant women between June 2021 and July 2022. Follow up was done after 3 months for all participating women who were diagnosed with placenta previa or accreta. 70 cases who were diagnosed with placenta accreta and subjected to the cervical advancement technique, and 70 cases who were diagnosed with placenta previa and not subjected to cervical advancement technique at Minia University Mternity Hospital. Results: With a p-value of less than 0.05, the mean of the cervical length, the inner-to-inner diameter, the cervical shape and the position of the cervix show a statistically significant difference between the two included groups. Conclusion: cervix isn't abnormally affected in cases of placenta accreta when managed by the cervical advancement technique.

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Section: Discussionmentioning

confidence: 99%

Section: Short Term Follow Up For Morphological Cervical Changes In C...mentioning

confidence: 99%

Short term follow up for morphological cervical changes in cases of placenta accreta managed by cervical advancement as a natural tamponade

Mousa

Abdelhamid

Yassien

et al. 2022

Minia Journal of Medical Research

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“…The lower segment is folded by means of a purse-string suture from the upper edge of the lower segment to the internal cervical os including both anterior and lateral aspects of lower uterine segment, followed by closure of the uterine incision [ 81 ]. An alternative method is the modified cervical inversion technique [ 82 ]. Other innovations include use of a vessel sealing system to dissect the bladder from the lower uterine segment and a linear cutter to create a bloodless hysterotomy [ 83 ].…”

Section: Innovative Measures To Control Lower Uterine Segment Haemorr...mentioning

confidence: 99%

Novel concepts and improvisation for treating postpartum haemorrhage: a narrative review of emerging techniques

Hofmeyr¹

2023

Reprod Health

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Background Most treatments for postpartum haemorrhage (PPH) lack evidence of effectiveness. New innovations are ubiquitous but have not been synthesized for ready access. Narrative review Pubmed 2020 to 2021 was searched on ‘postpartum haemorrhage treatment’, and novel reports among 755 citations were catalogued. New health care strategies included early diagnosis with a bundled first response and home-based treatment of PPH. A calibrated postpartum blood monitoring tray has been described. Oxytocin is more effective than misoprostol; addition of misoprostol to oxytocin does not improve treatment. Heat stable carbetocin has not been assessed for treatment. A thermostable microneedle oxytocin patch has been developed. Intravenous tranexamic acid reduces mortality but deaths have been reported from inadvertent intrathecal injection. New transvaginal uterine artery clamps have been described. Novel approaches to uterine balloon tamponade include improvised and purpose-designed free-flow (as opposed to fixed volume) devices and vaginal balloon tamponade. Uterine suction tamponade methods include purpose-designed and improvised devices. Restrictive fluid resuscitation, massive transfusion protocols, fibrinogen use, early cryopreciptate transfusion and point-of-care viscoelastic haemostatic assay-guided blood product transfusion have been reported. Pelvic artery embolization and endovascular balloon occlusion of the aorta and pelvic arteries are used where available. External aortic compression and direct compression of the aorta during laparotomy or aortic clamping (such as with the Paily clamp) are alternatives. Transvaginal haemostatic ligation and compression sutures, placental site sutures and a variety of novel compression sutures have been reported. These include Esike’s technique, three vertical compression sutures, vertical plus horizontal compression sutures, parallel loop binding compression sutures, uterine isthmus vertical compression sutures, isthmic circumferential suture, circumferential compression sutures with intrauterine balloon, King’s combined uterine suture and removable retropubic uterine compression suture. Innovative measures for placenta accreta spectrum include a lower uterine folding suture, a modified cervical inversion technique, bilateral uterine artery ligation with myometrial excision of the adherent placenta and cervico-isthmic sutures or a T-shaped lower segment repair. Technological advances include cell salvage, high frequency focussed ultrasound for placenta increta and extra-corporeal membrane oxygenation. Conclusions Knowledge of innovative methods can equip clinicians with last-resort options when faced with haemorrhage unresponsive to conventional methods.

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Endometrial injury in women undergoing in vitro fertilisation (IVF)

Lensen

Armstrong

Gibreel

et al. 2021

Cochrane Database of Systematic Reviews

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Alalfy modified cervical inversion technique as a tamponade in controlling PPH in placenta previa, a multicentric double blind randomized controlled trial

Cited by 4 publications

References 19 publications

Short term follow up for morphological cervical changes in cases of placenta accreta managed by cervical advancement as a natural tamponade

Short term follow up for morphological cervical changes in cases of placenta accreta managed by cervical advancement as a natural tamponade

Novel concepts and improvisation for treating postpartum haemorrhage: a narrative review of emerging techniques

Endometrial injury in women undergoing in vitro fertilisation (IVF)

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