Prevention of Postpartum Hemorrhage Using Vacuum Retraction Cannula during Cesarean Section in Major Degree Placenta Previa

Abstract

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.