A Novel Tourniquet Technic for Massive PPH

NCT ID: NCT02997397

Last Updated: 2016-12-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

37 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-12-31

Study Completion Date

2016-04-30

Brief Summary

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In this study, the investigators aimed to find out the effect of a novel tourniquet technique, in cases of excessive bleeding during cesarean delivery.

Detailed Description

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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.

Conditions

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Postpartum Hemorrhage

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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tourniquet (+)

The cases in which the tourniquet technique is used

tourniquet(+)

Intervention Type PROCEDURE

A novel atraumatic tourniquet technique, applied via placing a vascular clamp widely on both the infundibulopelvic ligament and uterine arteries.

tourniquet(-)

The cases in which the tourniquet technique is not used

tourniquet(-)

Intervention Type PROCEDURE

Interventions

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tourniquet(+)

A novel atraumatic tourniquet technique, applied via placing a vascular clamp widely on both the infundibulopelvic ligament and uterine arteries.

Intervention Type PROCEDURE

tourniquet(-)

Intervention Type PROCEDURE

Other Intervention Names

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The tourniquet was not used

Eligibility Criteria

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Inclusion Criteria

* The women who experienced profuse postpartum haemorrhage during cesarean section

Exclusion Criteria

* none defined
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Irenbe

OTHER

Sponsor Role lead

Responsible Party

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Baris Buke

M.D.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Barış Büke, resident

Role: PRINCIPAL_INVESTIGATOR

İRENBE

Locations

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Ege University

Izmir, İzmir, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ. The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol. 1997 Mar;104(3):372-5. doi: 10.1111/j.1471-0528.1997.tb11471.x.

Reference Type RESULT
PMID: 9091019 (View on PubMed)

Hayman RG, Arulkumaran S, Steer PJ. Uterine compression sutures: surgical management of postpartum hemorrhage. Obstet Gynecol. 2002 Mar;99(3):502-6. doi: 10.1016/s0029-7844(01)01643-x.

Reference Type RESULT
PMID: 11864681 (View on PubMed)

AbdRabbo SA. Stepwise uterine devascularization: a novel technique for management of uncontrolled postpartum hemorrhage with preservation of the uterus. Am J Obstet Gynecol. 1994 Sep;171(3):694-700. doi: 10.1016/0002-9378(94)90084-1.

Reference Type RESULT
PMID: 8092217 (View on PubMed)

Ikeda T, Sameshima H, Kawaguchi H, Yamauchi N, Ikenoue T. Tourniquet technique prevents profuse blood loss in placenta accreta cesarean section. J Obstet Gynaecol Res. 2005 Feb;31(1):27-31. doi: 10.1111/j.1447-0756.2005.00247.x.

Reference Type RESULT
PMID: 15669988 (View on PubMed)

Other Identifiers

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IR-2016-01

Identifier Type: -

Identifier Source: org_study_id