Exteriorization of uterus before placental expulsion and intra-myometrial oxytocin versus in situ repair and IV oxytocin during LSCS – A comparative study
Journal Title: Indian Journal of Obstetrics and Gynecology Research - Year 2018, Vol 5, Issue 1
Abstract
Introduction: A suitable modification of any step of caesarean section to reduce blood-loss should be considered as the morbidity and mortality of CS is mostly associated with excessive hemorrhage. Aim: This is a comparative study of uterine exteriorization and intra-myometrial (IMM) oxytocin 5 IU before placental expulsion with conventional method of intra-abdominal repair with 10 IU IV oxytocin with primary objective to compare the blood-loss. Materials and Methods: A prospective study of 2 groups, 100 women in each group (Primis & 2nd gravidas between 19-34 years of age) having hemoglobin above 10 gm% in cephalic presentation with almost identical indications for CS excluding prematurity, APH, IUGR, bleeding disorders, fibroids etc. Standard caesarean procedure followed except exteriorization of uterus before placenta delivery and IMM oxytocin 5 IU in Gr1; and intra-abdominal repair and slow IV 10 IU oxytocin in Gr2. Preoperative, Postoperative and difference of Hb, duration of surgery from baby birth to starting of abdominal closure, blood-loss by volumetric method noted and compared after mean calculation by student t and chi-square test. Intra-operative and post-operative complications compared by relative risk calculation. Results: The values of postoperative Hb level 99.2 against 89.2g/l, Hb difference between pre- and postoperative level 12.7 against 23.2g/l, blood loss 394.8 ml against 461.6 ml, duration of surgery 11 min 10 sec against 19 min 53 sec were highly significant (p < 0.0001 by student t and chi square test). The hospital stay with relative risk calculation shows significant difference between 2 groups. Conclusion: Exteriorization of uterus before placental separation and IMM oxytocin reduces not only blood loss and time taken in caesarean sections, also the hospital stay.
Authors and Affiliations
Sahadev Sahoo, Debraj Mondal, Amar Nath Gupta, Ajit Ranjan Bhattacharya
Keywords
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- EP ID EP472849
- DOI 10.18231/2394-2754.2018.0003
- Views 84
- Downloads 0
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