Effect of Uterine Artery Ligation Prior to Uterine Incision in Women With Placenta Previa

Not Applicable

• Conditions: Placenta Previa
• Interventions: Procedure: uterine artery ligation; Procedure: Lower segment Cesarean section

• Registration Number: NCT03124472
• Lead Sponsor: Cairo University

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

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study First Submitted: 2017-04-19
• Study First Submitted QC: 2017-04-19
• Study First Posted: 2017-04-21
• Study Start: 2017-06-01
• Status Verified: 2018-01
• Last Update Submitted: 2018-01-30
• Last Update Posted: 2018-01-31
• Primary Completion: 2018-05
• Study Completion: 2018-06

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: Female
• Target Recruitment: 200

Inclusion Criteria

• patients diagnosed with placenta praevia antenatally
• plan is elective caesarean section
• Gestational age >34 weeks

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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

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
uterine artery ligation	Lower 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. * 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.
Traditional lower segment Cesarean section	Lower 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.
uterine artery ligation	uterine artery ligation	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.

Primary Outcome Measures

Name	Time	Method
Decrease in Hemoglabin level	24 hours after Cesarean

Trial Locations

Locations (1)

Kasr Alainy medical school; 🇪🇬 Cairo, Egypt