Effect of Uterine Artery Ligation Prior to Uterine Incision in Women With Placenta Previa

Study Overview
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Brief Summary
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Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. Uterine artery ligation was performed by grasping the broad ligament with thumb anterior and the index finger lifting the base below the site uterine incision; the uterine artery was singly ligated with No. 1 vicryl suture. Myometrium was included so that uterine vessels are not damaged. Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta Delivery of the baby and placenta. Closure of the uterine incision in 2 layers with N0. 1 vicryl suture. Closure of the anterior abdominal wall in layers

Detailed Description
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Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. Uterine artery ligation was performed by grasping the broad ligament with thumb anterior and the index finger lifting the base below the site uterine incision; the uterine artery was singly ligated with No. 1 vicryl suture. Myometrium was included so that uterine vessels are not damaged. Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta Delivery of the baby and placenta. Closure of the uterine incision in 2 layers with N0. 1 vicryl suture. Closure of the anterior abdominal wall in layers In the control group, lower segment caesarean section is without uterine artery ligation

Official Title
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Effect of Uterine Artery Ligation Prior to Uterine Incision in Women With Placenta Previa

Conditions
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Placenta Previa

Intervention / Treatment
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* Procedure: uterine artery ligation
* Procedure: Lower segment Cesarean section


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients diagnosed with placenta praevia antenatally plan is elective caesarean section Gestational age >34 weeks Exclusion Criteria: Fetal distress medical disorders as hypertension or Diabetes Mellitus Coagulation defects. Emergency Cesarean section women with antepartum hemorrhage patients with marked ahdesions or those with non possible uterine artery ligation

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: uterine artery ligation<br>Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. Uterine artery ligation was performed by grasping the broad ligament with thumb anterior and the index finger lifting the base below the site uterine incision; the uterine artery was singly ligated with No. 1 vicryl suture. Myometrium was included so that uterine vessels are not damaged. Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta. | Procedure: uterine artery ligation<br>* Uterine artery ligation was performed by grasping the broad ligament with thumb anterior and the index finger lifting the base below the site uterine incision; the uterine artery was singly ligated with No. 1 vicryl suture. Myometrium was included so that uterine vessels are not damaged<br>Procedure: Lower segment Cesarean section<br>* Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. - The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta Delivery of the baby and placenta. Closure of the uterine incision in 2 layers with N0. 1 vicryl suture. Closure of the anterior abdominal wall in layers<br>|
| Active Comparator: Traditional lower segment Cesarean section<br>Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta. | Procedure: Lower segment Cesarean section<br>* Pfannenstiel incision of skin and opening of the anterior abdominal wall in layers. - The loose peritoneum of the lower uterine segment is dissected downwards to mobilize the urinary bladder and expose the lower uterine segment. Cresenteric lower uterine segment incision was performed as usual. Higher incisions were performed in cases where the traditional incision was expected to be directly through the placenta Delivery of the baby and placenta. Closure of the uterine incision in 2 layers with N0. 1 vicryl suture. Closure of the anterior abdominal wall in layers<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Decrease in Hemoglabin level |  | 24 hours after Cesarean |