Postpartum Hemorrhage Clinical Trial
Official title:
A Novel Atraumatic Tourniquet Technique in Cases of Excessive Bleeding During Cesarean Section
In this study, the investigators aimed to find out the effect of a novel tourniquet technique, in cases of excessive bleeding during cesarean delivery.
In this retrospective comparative study, the investigators compared the peripartum features
of patients who experienced profuse postpartum bleeding during C/S and this novel atraumatic
tourniquet technique was used and not used.
In this technique; the uterus is exteriorized following the delivery of the baby and before
the removal of the placenta to be able to apply the tourniquet technique. In this technique
it is not obligatory to push the bladder before the procedure. Afterwards, the surgeon and
the assistant palpate the ureters with both hands in the two sheaths of broad ligament and
try to hear a 'click' sound which comes from ureter sliding out between both fingers. After
confirming that the ureters are not in the surgical site, an atraumatic vascular DeBakey
clamp is applied widely including both the infundibulopelvic ligament and uterine arteries.
Thus, two-sided blood supply of the uterus is reduced significantly and this gives the
surgeon some time, for planning further surgical procedures and also serves a minimal bloody
surgical site. If the avascular state of the surgical site is needed for a prolonged time,
for instance while preparing for a blood transfusion or while waiting until an experienced
surgeon is available, the clamps were opened and closed intermittently for a maximum of 10
minutes, as to sustain the blood supply of the ovaries and the uterus.
;
Observational Model: Case Control, Time Perspective: Retrospective
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