Mostafa Maged Technique to Control and Prevent the Post-Partum Bleeding From the Lower Uterine Segment in Placenta Previa Cases
Condition: Placenta Previa
MeSH terms: Placenta Previa; Postpartum Hemorrhage
Study type: Interventional

Summary: 
      Post - partum haemorrhage is still a headache to all obstetricians around the whole world .
      Every obstetrician exerts his own full effort to control bleeding which can occur post-partum
      by applying all maneuvers to preserve the fertility and the uterus for the patient .

      demonstration of ( Mostafa Maged ) technique is applied to control and prevent post-partum
      haemorrhage . It is so simple maneuver and easy to be applied within short period of time
      .Satisfactory hemostasis can be assessed after application .
    

Detailed description: 
      1. pfannestiel incision .

        2. dissection of the bladder downwards , and then making an incision in the lower segment
           of the uterus , then the uterus is evacuated from the fetus and placenta .

        3. Ligation of the uterine arteries on both sides is applied before proceeding and after
           the extraction of fetus and placenta .

      5) The lower segment was bleeding so trying to do bimanual compression of the anterior and
      posterior parts of lower uterine segments to test if Mostafa Maged technique is useful in
      these cases or not (( by observing if the bleeding is minimized or stopped or not by
      compression )) as if it is minimized so our technique has a high chance to be effective .

      6) The whole technique depends on the anterior lower uterine segment by dividing the anterior
      lower uterine segment by an imaginary line in two halves , then , turning over (flipping )
      the upper part of the lower uterine segment onto the lower part of the lower uterine segment
      from the inside of uterine cavity .

      7) doing this turnover (flipping ) by the hands and holding the imaginary line by two Allis
      forceps and by making three knots by three needles in the lower edge of the uterine incision
      and entering the needles of (absorbable 70 mm rounded-bodied vicryl 1 ) simultaneously into
      the lower segment through the uterine cavity , at the same level of , the inside wall of
      lower uterine segment in order to drag the upper (half) part of the lower uterine segment on
      the lower part of lower uterine segment ( sandwich - like ) , and after this maneuver the
      bleeding is re-evaluated again .

      8) Third , stitching the both sides of the flipped lower uterine segment by ( absorbable 70
      mm rounded-bodied vicryl 1 ) , then doing plication of the anterior lower uterine segments to
      strengthen the wall of the flipped lower uterine segment and secure the tension .

      9) Fourth , closing the caeserian scar by suturing the already-flipped lower uterine segment
      onto the upper uterine segment .

      10) placing a drain in the doglus pouch
    

Intervention name(s): Mostafa Maged Technique
Intervention type(s): Procedure
Intervention description(s): pfannestiel incision . dissection of the bladder downwards , and Ligation of the uterine arteries on both sides then , we turn over the upper part of the lower uterine segment onto the lower part of the lower uterine segment from the inside of uterine cavity .We do this turnover (flipping ) by our hands and holding the imaginary line by two Allis forceps and by making three knots by three needles in the lower edge of the uterine incision and we enter the needles of simultaneously into the lower segment through the uterine cavity , at the same level of , the inside wall of lower uterine segment to drag the upper (half) part of the lower uterine segment on the lower part of lower uterine segment ( sandwich - like ) Third , we stitch the both sides of the flipped lower uterine segment , then we do plication of the anterior lower uterine segments to strengthen the wall of the flipped lower uterine segment and place a drain in the doglus pouch
Intervention model: Single Group Assignment
Intervention model description: primigravida pregnant patients with placenta previa conditions
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Mostafa Maged technique; placenta previa; lower uterine segment; caeserian section