Citation Information :
Miuli I, Arumugam SC, Srinivasan S. Prevention of Postpartum Hemorrhage Using Vacuum Retraction Cannula during Cesarean Section in Major Degree Placenta Previa. J South Asian Feder Obs Gynae 2023; 15 (4):395-398.
Aim: To evaluate the effectiveness of a vacuum retraction cannula (VRC) for the prevention of postpartum hemorrhage (PPH) in major degree placenta previa (PP).
Materials and methods: The study was an ambidirectional interventional cohort study undertaken in the Department of Obstetrics and Gynaecology, for 18 months in the tertiary care center, after obtaining the Institute Human Ethical Committee (IHEC) clearance. The effectiveness of a VRC was evaluated in pregnant women undergoing an elective or emergency cesarean section for major degree placenta previa. The primary outcome was the number of cases that were prevented from PPH.
Results: Out of a total of 15 patients, the treatment prevention rate in our study was estimated to be 20% (95% confidence interval [CI]: 17.5–22.5). The mean total blood loss intraoperatively was 1218.57 mL (1132.23–1304.91). The total mean duration for the cannula kept in situ was 940.71 minutes (821.12–1060.31). In total, 6 (40%) patients had received blood products. The average of preoperative hemoglobin was 11.06 g/dL (10.76–11.37) and the postop day 2 hemoglobin was 9.05 mg/dL (8.67–9.42). The median length of hospital stay was 5.46 ± 0.84 days. Device-related superficial vaginal tear incurred in 2 (14.29%) patients.
Conclusion: Prophylactic application of a VRC in major degree placenta previa can prevent catastrophic bleeding.
Clinical significance: The device is cost-effective and provides a rapid modality of treatment options for one of the highest risk cases in obstetrics and gynecology.
Fan D, Xia Q, Liu L, et al. The incidence of postpartum hemorrhage in Pregnant Women with placenta previa: A systematic review and meta-analysis. PloS One 2017;12(1):e0170194. DOI: 10.1371/journal.pone.0170194.
Kumari S, Singh B. Maternal and perinatal outcome of placenta previa in a tertiary care centre: An observational study. Int J Reprod Contracept Obstet Gynecol 201825;7(11):4701–4705. DOI: 10.18203/2320-1770.ijrcog20184533.
Krupa BM, Asha S, Padma, et al. Pregnancy outcomes in various types of placenta previa: A clinical study. J Gynecol Women's Health 2021:21(5):556073. DOI: 10.19080/JGWH.2021.21.556073.
Gibbins KJ, Einerson BD, Varner MW, et al. Placenta previa and maternal hemorrhagic morbidity. J Matern Fetal Neonatal Med 2018;31(4):494–499. DOI: 10.1080/14767058.2017.1289163.
Peng ZH, Xiong Z, Zhao BS, et al. Prophylactic abdominal aortic balloon occlusion: An effective method of controlling hemorrhage in patients with placenta previa or accreta. Exp Ther Med 2019;17(2):1492–1496. DOI: 10.3892/etm.2018.7066.
Ryu JM, Choi YS, Bae JY. Bleeding control using intrauterine continuous running suture during cesarean section in pregnant women with placenta previa. Arch Gynecol Obstet 2019;299(1):135–139. DOI: 10.1007/s00404-018-4957-4.
Suarez S, Conde–Agudelo A, Borovac–Pinheiro A, et al. Uterine balloon tamponade for the treatment of postpartum hemorrhage: A systematic review and meta-analysis. Am J Obstet Gynecol 2020;222(4):293.e1–293.e52. DOI: 10.1016/j.ajog.2019.11.1287.
Grange J, Chatellier M, Chevé MT, et al. Predictors of failed intrauterine balloon tamponade for persistent postpartum hemorrhage after vaginal delivery. PloS One 2018;13(10):e0206663. DOI: 10.1371/journal.pone.0206663.
Silver RM, Branch DW. Placenta accreta spectrum. N Engl J Med 2018;378(16):1529–1536. DOI: 10.1056/NEJMcp1709324.
Bingham D, Lyndon A, Lagrew D, et al. A state-wide obstetric hemorrhage quality improvement initiative. MCN Am J Matern Child Nurs 2011;36(5):297–304. DOI: 10.1097/NMC.0b013e318227c75f.
Panicker TNV. Panicker's vacuum suction haemostatic device for treating post-partum haemorrhage. J Obstet Gynecol India 2017;67(2):150–151. DOI: 10.1007/s13224-017-0963-x.
Meena M, Meena D. A clinical study of the use of SR vaccum suction cannula in the management of atonic PPH at tertiary care hospital. Int J Sci Res 2020;9(1):1812–1815. DOI: 10.21275/ART20204495.
D’Alton ME, Rood KM, Smid MC, et al. Intrauterine vacuum-induced hemorrhage–control device for rapid treatment of postpartum hemorrhage. Obstet Gynecol 2020;136(5):882–891. DOI: 10.1097/AOG.0000000000004138.