Prophylactic hypogastric arterial ligation before cesarean hysterectomy for controlling complications in pregnant women with placenta adherent abnormality: A randomized controlled clinical trial

Prophylactic hypogastric arterial ligation before cesarean hysterectomy for controlling complications in pregnant women with placenta adherent abnormality A randomized controlled clinical trial

BackgroundPlacenta adherent abnormality (PAA) is abnormal attachment of the placenta to the myometrium. This abnormal placenta binding has severe clinical consequences for the mother and the fetus. We investigated the outcomes of hypogastric arterial ligation (HAL) before hysterectomy compared to hy...

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Bibliographic Details
Published in:Journal of research in medical sciences Vol. 27; no. 1; p. 63
Main Authors: Movahedi, Minoo, Niakan, Zahra, Shahshahan, Zahra, Hooshmand Meibodi, Amir Reza, Babak, Anahita, Saeidi, Mahmoud
Format: Journal Article
Language:English
Published: India Medknow Publications and Media Pvt. Ltd 01-01-2022
Wolters Kluwer - Medknow
Wolters Kluwer Medknow Publications
Subjects:
Clinical trials
deep vein thrombosis
Health aspects
hemorrhage
hypogastric
Hysterectomy
Original
placenta accrete
Pregnant women
Product development
Surgery
Tranexamic acid
Women
Iran
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Summary:BackgroundPlacenta adherent abnormality (PAA) is abnormal attachment of the placenta to the myometrium. This abnormal placenta binding has severe clinical consequences for the mother and the fetus. We investigated the outcomes of hypogastric arterial ligation (HAL) before hysterectomy compared to hysterectomy alone in pregnant women with PAA. Materials and MethodsIn this randomized controlled clinical trial, 70 patients were randomly allocated to HAL along with hysterectomy and hysterectomy alone groups (35 in each Group). The total amount of intraoperative blood loss, the need for intraoperative blood products transfusion, frequency of deep vein thrombosis, duration of surgery, duration of hospitalization, and visceral trauma were compared between 2 Groups. ResultsFinally, 64 patients completed the study protocol with mean age of 33.84 ± 4.25 years. The study groups were comparable in terms of basic baseline demographic and clinical characteristics. Visceral trauma was less frequently occurred in HAL group compared to hysterectomy alone (0% vs. 15.6%; P = 0.02). Intraoperative blood loss (1525 ± 536.41 cc vs. 2075 ± 889.36 cc; P = 0.001) and were significantly lower in HAL group compared to hysterectomy alone. Duration of operation (179.06 ± 36.28 vs. 197.66 ± 39.47; P = 0.05) and hospitalization (4.97 ± 2.20 vs. 6.10 ± 2.39; P = 0.03) also were significantly lower in HAL group. ConclusionOur findings suggest that prophylactic HAL has a protective effect on the reduction of blood loss and less visceral trauma in pregnant women with PAA.
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ISSN:1735-1995
1735-7136
DOI:10.4103/jrms.jrms_763_21