Compression of the lower uterine segment (COLUS) is an effective method of bleeding cessation during caesarean section on the background of placenta previa
Keywords:placenta previa, bleeding, caesarean section, compression of the lower uterine segment
Objective: to study the hemostatic efficacy of compression of the lower uterine segment (COLUS) as a new method to stopping bleeding during cesarean section on the background of placenta previa.
Materials and methods. The main group included 30 women with placenta previa, who were routinely delivered by cesarean section and using the COLUS technique after separation and isolation of placenta during a gestation period of 36 weeks – 36 weeks + 6 days. The control group consisted of 31 pregnant women with placenta previa, who had a planned delivery by сesarean section using the classical technique of suturing the uterus at a gestational age of 38–39 weeks. After separation and isolation of the placenta placental bleeding was stopped by flashing and coagulation of bleeding vessels in lower uterine segment.
Results. In the control group after standard caesarean section technique a high percentage of blood loss from 1000 ml or more was observed, that is typical for operations performed with placenta previa. In the main group a significantly smaller number of cases of blood loss from 1000 ml or more were observed. The average volume of blood loss in the control group was 1277 ± 119 ml, and 697 ± 139 ml in the main group, that is indicates the high efficiency of the COLUS technique. This technique allows to reduce blood loss by 45% of the blood loss of the control group. There was no significant difference in the condition of the newborns in both groups.Conclusions. The data obtained indicate the advisability of delivery of pregnant women with placenta previa in the gestation period of 36 weeks – 36 weeks + 6 days. Performing a cesarean section in the absence of a developed lower uterine segment in combination with the COLUS technique is an effective and safe surgical method for prevention of blood loss in a complex of therapeutic measures to prevent massive obstetric bleeding. It is an addition to surgical means to stop bleeding from the lower uterine segment after separation and removal of the underlying placenta
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