RETRACTED ARTICLE: The effect of uterine artery ligation in patients with central placenta pevia: a randomized controlled trial

Abstract

BackgroundPlacenta previa is major obstetric surgical risk as it is associated with higher percentage of intraoperative and postpartum hemorrhage (PPH), increased requirement of blood transfusion and further surgical procedures. The current study aimed to evaluate uterine artery ligation prior to uterine incision as a procedure to minimize blood loss during cesarean section in patients with central placenta previa.MethodsOne hundred and four patients diagnosed with central placenta previa antenatally and planned to have elective caesarean section were recruited from the antenatal clinic at Minia Maternity University hospital. Patients were randomly allocated into either ligation group or control group.ResultsBoth groups were similar regarding demographic features and preoperative risk factors for bleeding. The intraoperative blood loss was significantly lower in the ligation group as compared with the control group (569.3 ± 202.1 mL vs. 805.1 ± 224.5 mL respectively, p = 0.002). There was a significant increase in the requirement for blood transfusion in the control group as compared with the ligation group (786 ± 83 mL vs. 755 ± 56 mL respectively, p = 0.03) Three cases in the control group required further surgical interventions to control intraoperative bleeding, while no cases in the ligation required further surgical techniques and that was statistically significant (p = 0.001).ConclusionUterine artery ligation prior to uterine incision may be a helpful procedure to minimize intraoperative and postpartum blood loss in cases with central placenta previa.Trial registrationRetrospectively registered in ClinicalTrials.gov Identifier: NCT02002026- December 8, 2013.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1989-5) contains supplementary material, which is available to authorized users.

Combined Uterine Artery Ligation, Segmental Myometrial Resection and Intrauterine Balloon to Control Bleeding from Placenta Previa Accreta during Caesarean Section

“…The combination of more than hemostatic measure before removal of placenta could explain the excellent outcome in the current study. These results agree with Zhao et al [8] , Tskhay et al [9] and Sanad et al [10] regarding patient age, gravidity, parity and residence.…”

Análise das intervenções utilizadas na prevenção e controle da hemorragia pós-parto: revisão integrativa da literatura

“…Os quatorze estudos fizeram caracterização clínica das intervenções, conforme mostra o quadro 4. Todos os estudos descreveram o tipo de parto onde ocorreu a intervenção no manejo da hemorragia pós-parto, sendo prevalente o parto vaginal (Rangel et al, 2019;Begley et al, 2019;Salati et al, 2019;Asmat et al, 2017;Quibel et al, 2016;Suarez et al, 2020;Escobar et al, 2020;Şentürk et al, 2016;Sanad et al, 2018;Gallos et al, 2018;Woman et al, 2017;Anger et al, 2019;Maged et al, 2019;Amornpetchakul et al, 2018).…”

“…Quanto a perda sanguínea das puérperas na hemorragia pós-parto, os seguintes estudos mostraram que o volume variou de ≥500 a ≥2000mL (Begley et al, 2019;Salati et al, 2019;Asmat et al, 2017;Quibel et al, 2016;Suarez et al, 2020;Escobar et al, 2020;Şentürk et al, 2016;Sanad et al, 2018;Gallos et al, 2018;Woman et al, 2017;Maged et al, 2019;Amornpetchakul et al, 2018).…”

“…gestantes multíparas, grandes multíparas, placenta prévia, placenta acreta, placenta retida, descolamento prematuro de placenta, atonia uterina, coagulopatia, produtos retidos da concepção, distúrbios hipertensivos e nuliparidade (Asmat et al, 2017;Suarez et al, 2020;Escobar et al, 2020;Sanad et al, 2018;Amornpetchakul et al, 2018).…”

“…Um número relativamente pequeno de estudos realizou caracterização sociodemográfica, nos estudos que avaliaram, a faixa etária variou de 18 a 44 anos (Asmat et al, 2017;Şentürk et al, 2016;Sanad et al, 2018;Woman et al, 2017;Anger et al, 2019;Maged et al, 2019;Amornpetchakul et al, 2018).…”