Bilateral Uterine Artery Ligation During the Cesarean Delivery of Twins

Study Overview
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Brief Summary
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Objective to assess the effectiveness of prophylactic bilateral uterine artery ligation (BUAL) in reducing the incidence of postpartum hemorrhage during cesarean delivery among women with twin pregnancy

Detailed Description
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A randomized clinical trial at Aswan University Maternity Hospital, Egypt. Women with twin pregnancy undergoing scheduled or emergency cesarean were randomized into two groups. In the BUAL group, women underwent BUAL before placental delivery; in the control group, women had cesarean delivery without BUAL. The primary outcome was the estimated blood loss during a cesarean

Official Title
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Clinical Outcomes of Bilateral Uterine Artery Ligation During the Cesarean Delivery of Twins: A Randomized Controlled Trial

Conditions
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Cesarean Section Complications

Intervention / Treatment
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* Procedure: bilateral uterine artery ligation
* Drug: Oxytocin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: women undergoing cesarean section twin pregnancy Exclusion Criteria: Placenta previa. Ante-partum hemorrhage. patient refuse to participate

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 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
Interventional Model Description: randomized controlled study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: study group<br>patients with twin pregnancy undergoing cesarean section underwent bilateral uterine artery ligation and received oxytocin. | Procedure: bilateral uterine artery ligation<br>* The peritoneum over the vesico-uterine pouch already being incised horizontally, the peritoneum over the uterine isthmus and cervix was dissected downwards, and this dissection was then extended laterally<br>* Other names: BUAL;Drug: Oxytocin<br>* 20 units by slow intravenous drip injection<br>|
| Active Comparator: control group<br>patients with twin pregnancy undergoing cesarean section received oxytocin only. | Drug: Oxytocin<br>* 20 units by slow intravenous drip injection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mean Blood loss after placental separation | by using weight of soaked towels (weight of soaked towel - weight of dry towel) and amount of blood in suction set | 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants with postpartum hemorrhage | number pf participants with blood loss > 1000ml | 12 hours | 
| The number of participant needed for blood transfusion | Calculation of the number of participant needed for blood transfusion | 24 hours |