Effect of uterine artery ligation prior to uterine incision in cases of placenta previa complete centralis / Ahmed Ezzat Eldesouki Ali ; Supervised Ahmed Mohamed Ahmed Sayed Elgazzar , Hany Saad Amin , Mohamed Ramdan Mohamed

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynaecology and Obstetrics

Background: Placenta previa is a 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. Methods: Fifty Four patients were diagnosed with central placenta previa antenatally and planned to have elective caesarean section were recruited from the antenatal clinic at Cairo University hospital. Patients were randomly allocated into either ligation group or control group. Results: Both 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 {931(817,1091) mL, vs. 1811(1575,1917)mL respectively, P= <0.001}. There was a significant increase in the requirement for further surgical intervention in the control group as compared with the ligation group (55.50% vs. 3.70% of cases respectively, p= <0.001), as fifteen cases in the control group required further surgical interventions to control intraoperative bleeding, while only one case in the ligation required further surgical techniques and that was statistically significant (p= <0.001)

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