Placenta Previa
Conditions
Brief summary
Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. * The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. * Uterine artery ligation was performed by grasping the broad ligament with thumb anterior and the index finger lifting the base below the site uterine incision; the uterine artery was singly ligated with No. 1 vicryl suture. Myometrium was included so that uterine vessels are not damaged. * Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta Delivery of the baby and placenta. * Closure of the uterine incision in 2 layers with N0. 1 vicryl suture. * Closure of the anterior abdominal wall in layers
Detailed description
Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. * The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. * Uterine artery ligation was performed by grasping the broad ligament with thumb anterior and the index finger lifting the base below the site uterine incision; the uterine artery was singly ligated with No. 1 vicryl suture. Myometrium was included so that uterine vessels are not damaged. * Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta Delivery of the baby and placenta. * Closure of the uterine incision in 2 layers with N0. 1 vicryl suture. * Closure of the anterior abdominal wall in layers In the control group, lower segment caesarean section is without uterine artery ligation
Interventions
PROCEDUREuterine artery ligation
Uterine artery ligation was performed by grasping the broad ligament with thumb anterior and the index finger lifting the base below the site uterine incision; the uterine artery was singly ligated with No. 1 vicryl suture. Myometrium was included so that uterine vessels are not damaged
PROCEDURELower segment Cesarean section
Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. \- The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta Delivery of the baby and placenta. * Closure of the uterine incision in 2 layers with N0. 1 vicryl suture. * Closure of the anterior abdominal wall in layers
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
19 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* patients diagnosed with placenta praevia antenatally * plan is elective caesarean section * Gestational age \>34 weeks
Exclusion criteria
* Fetal distress * medical disorders as hypertension or Diabetes Mellitus * Coagulation defects. * Emergency Cesarean section * women with antepartum hemorrhage * patients with marked ahdesions or those with non possible uterine artery ligation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Decrease in Hemoglabin level | 24 hours after Cesarean |
Countries
Egypt
Contacts
Primary ContactAhmed Maged, MD
Outcome results
None listed