Effect of Uterine Artery Clamping in Reducing Cesarean Hysterectomy in Pregnancies Complicated by Placenta Accrete Spectrum

Background and objective: The placenta accreta spectrum is a major public health problem. Many interventional measures are used for controlling hemorrhage and preventing emergency caesarean hysterectomy. The aim of this study was to evaluate the role of uterine artery clamping in reducing maternal...

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Main Authors: Balen Mohammad Jabar, Maryam Bakir Mahmood, Taher Abdullah Hussein Hawramy, Naz Azad Abdullah
Format: Article
Language:English
Published: Kurdistan Higher Council Of Medical Specialties 2024-03-01
Series:Advanced Medical Journal
Subjects:
Online Access:https://amj.khcms.edu.krd/index.php/main/article/view/377
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author Balen Mohammad Jabar
Maryam Bakir Mahmood
Taher Abdullah Hussein Hawramy
Naz Azad Abdullah
author_facet Balen Mohammad Jabar
Maryam Bakir Mahmood
Taher Abdullah Hussein Hawramy
Naz Azad Abdullah
author_sort Balen Mohammad Jabar
collection DOAJ
description Background and objective: The placenta accreta spectrum is a major public health problem. Many interventional measures are used for controlling hemorrhage and preventing emergency caesarean hysterectomy. The aim of this study was to evaluate the role of uterine artery clamping in reducing maternal morbidity and mortality in pregnancies complicated by placenta accrete spectrum. Methods: This is a retrospective case-control study implemented in the Sulaymaniyah Maternity Teaching Hospital in Sulaymaniyah city, Kurdistan region-Iraq through the period of 2 years from 1st of June 2020, to 31st of May, 2022. A sample of sixty pregnant women with placenta accreta spectrum surgically managed by elective cesarean section and divided into two study groups (32 women underwent elective cesarean section with uterine artery clamping [interventional group] and 28 women underwent elective cesarean section without uterine artery clamping [control group]. Results: The postoperative hemoglobin level was significantly higher in women of the interventional group with a mean of (10.1±0.7 gm/dL) compared to (9.3±1 gm/dL) in women of the control group. The mean of units of blood transfused was significantly lower in women of the interventional group with a mean of (1.3±0.6 units) compared to (3.1±1.4 units) in women of the control group. Also, there was a significant reduction in units of fresh frozen plasma in women of the interventional group with a mean of (0.9±0.6 units) compared to (2.9±1.5 units) in women of the control group. Conclusions: The uterine artery clamping before placental separation is helpful in reducing the rate of maternal morbidity and mortality in pregnancies complicated by placenta accreta spectrum.  
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spelling doaj-art-bc9ae2ce2b6943eb8ee9a7e7da7d457d2025-08-20T02:27:24ZengKurdistan Higher Council Of Medical SpecialtiesAdvanced Medical Journal2958-89792957-35802024-03-019110.56056/amj.2024.250Effect of Uterine Artery Clamping in Reducing Cesarean Hysterectomy in Pregnancies Complicated by Placenta Accrete SpectrumBalen Mohammad Jabar0Maryam Bakir Mahmood1Taher Abdullah Hussein Hawramy2Naz Azad Abdullah3MBChB, KBMS/Obstetrics and Gynecology trainee; Sulaymaniyah Maternity Teaching Hospital-Sulaymaniyah-Kurdistan region/Iraq. MBChB, FICOG; Assistant Professor and Senior Lecturer in Obstetrics and Gynecology department at Medical collegeSulaymaniyah University-Kurdistan region/Iraq *MBChB, D.G.S, CABS, FACS, Consultant Surgeon, Sulaymaniyah-Kurdistan region/Iraq E-mail: hawramytahir@yahoo.comMBChB, CABOG, HDOG; Lecturer in Obstetrics and Gynecology department at Medical college-Sulaymaniyah University-Kurdistan region/Iraq Background and objective: The placenta accreta spectrum is a major public health problem. Many interventional measures are used for controlling hemorrhage and preventing emergency caesarean hysterectomy. The aim of this study was to evaluate the role of uterine artery clamping in reducing maternal morbidity and mortality in pregnancies complicated by placenta accrete spectrum. Methods: This is a retrospective case-control study implemented in the Sulaymaniyah Maternity Teaching Hospital in Sulaymaniyah city, Kurdistan region-Iraq through the period of 2 years from 1st of June 2020, to 31st of May, 2022. A sample of sixty pregnant women with placenta accreta spectrum surgically managed by elective cesarean section and divided into two study groups (32 women underwent elective cesarean section with uterine artery clamping [interventional group] and 28 women underwent elective cesarean section without uterine artery clamping [control group]. Results: The postoperative hemoglobin level was significantly higher in women of the interventional group with a mean of (10.1±0.7 gm/dL) compared to (9.3±1 gm/dL) in women of the control group. The mean of units of blood transfused was significantly lower in women of the interventional group with a mean of (1.3±0.6 units) compared to (3.1±1.4 units) in women of the control group. Also, there was a significant reduction in units of fresh frozen plasma in women of the interventional group with a mean of (0.9±0.6 units) compared to (2.9±1.5 units) in women of the control group. Conclusions: The uterine artery clamping before placental separation is helpful in reducing the rate of maternal morbidity and mortality in pregnancies complicated by placenta accreta spectrum.   https://amj.khcms.edu.krd/index.php/main/article/view/377Emergency cesarean sectionPlacenta accreta spectrumUterine artery ligation
spellingShingle Balen Mohammad Jabar
Maryam Bakir Mahmood
Taher Abdullah Hussein Hawramy
Naz Azad Abdullah
Effect of Uterine Artery Clamping in Reducing Cesarean Hysterectomy in Pregnancies Complicated by Placenta Accrete Spectrum
Advanced Medical Journal
Emergency cesarean section
Placenta accreta spectrum
Uterine artery ligation
title Effect of Uterine Artery Clamping in Reducing Cesarean Hysterectomy in Pregnancies Complicated by Placenta Accrete Spectrum
title_full Effect of Uterine Artery Clamping in Reducing Cesarean Hysterectomy in Pregnancies Complicated by Placenta Accrete Spectrum
title_fullStr Effect of Uterine Artery Clamping in Reducing Cesarean Hysterectomy in Pregnancies Complicated by Placenta Accrete Spectrum
title_full_unstemmed Effect of Uterine Artery Clamping in Reducing Cesarean Hysterectomy in Pregnancies Complicated by Placenta Accrete Spectrum
title_short Effect of Uterine Artery Clamping in Reducing Cesarean Hysterectomy in Pregnancies Complicated by Placenta Accrete Spectrum
title_sort effect of uterine artery clamping in reducing cesarean hysterectomy in pregnancies complicated by placenta accrete spectrum
topic Emergency cesarean section
Placenta accreta spectrum
Uterine artery ligation
url https://amj.khcms.edu.krd/index.php/main/article/view/377
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