The cervix as a natural tamponade in postpartum @entity548 caused by @entity5030 and XXXX accreta: a prospective study.

@entity1 @entity548 @entity1494 @entity190 @entity5030 @entity281 @entity86 @entity8052
BACKGROUND: Placenta previa and @entity8052 carry significant maternal and fetal morbidity and mortality. Several techniques have been described in the literature for controlling massive @entity548 associated with @entity5030 cesarean sections. The objective of this study was to evaluate the efficacy and safety of the use of the cervix as a natural tamponade in controlling postpartum @entity548 caused by @entity5030 and @entity5030 accreta. METHODS: This prospective study was conducted on 40 pregnant @entity1 admitted to our hospital between June 2012 and November 2014. All participating @entity1 had one or more previous cesarean deliveries and were diagnosed with @entity5030 and/or @entity5030 accreta. Significant @entity548 from the placental bed during cesarean section was managed by inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment. RESULTS: The technique of cervical inversion described above was successful in stopping the @entity548 in 38 out of 40 @entity1 ; yielding a success rate of 95  %. We resorted to hysterectomy in only two cases (5  %). The mean intra-operative @entity190 was 1572.5  mL, and the mean number of blood units transfused was 3.1. The mean time needed to perform the technique was 5.4        0.6  min. The complications encountered were as follows: @entity1494 in the two @entity1 who underwent hysterectomy and wound @entity281 in one @entity1 . @entity86 that responded to antibiotics occurred in 1 @entity1 . The mean duration of the postoperative hospital stay was 3.5  days CONCLUSIONS: This technique of using the cervix as a natural tamponade appears to be safe, simple, time-saving and potentially effective method for controlling the severe postpartum @entity548 (PPH) caused by @entity5030 accreta. This technique deserves to be one of the tools in the hands of obstetricians who face the life-threatening @entity548 . TRIAL REGISTRATION: ClinicalTrials.gov NCT02590484 . Registered 28 October 2015.
