Cervical Tourniquet Reduces Bleeding During Cesarean Sections

Cervical ligation using a cervical tourniquet during cesarean sections may reduce bleeding and avoid hysterectomy for individuals with placenta accreta, according to the results of a pilot study.

To study this surgical technique in which a cervical tourniquet is applied with a Foley catheter to preserve the uterus, researchers prospectively identified for study enrollment pregnant women at high risk of hysterectomy during cesarean section owing to massive bleeding from placenta accreta. The study ran from January 2021, to June 2021 and enrolled 11 women who each received a cesarean section operation with use of cervical ligation that was done by a single expert consultant obstetrician.

As a result of the intervention, the uterus was preserved in 9 patients, and 2 patients had a hysterectomy. Mean blood loss by patients whose uterus was preserved was 1689 mL, and the mean length of stay for the study patients was 5.5 days.

“Cervical ligation is a simple method that can be applied by junior and experienced obstetricians to preserve the uterus,” researchers concluded. “This maneuver should be useful. . . in emergency cases, and residents can apply the catheter around the cervix, decreasing the bleeding and allowing time until an experienced obstetrician arrives….[I]t can achieve hemostasis alone or with another procedure such as uterine artery ligation.”

—Ellen Kurek

Reference:

Altal OF, Qudsieh S, Ben-Sadon A, Hatamleh A, Bataineh A, Halalsheh O, Amarin Z. Cervical tourniquet during cesarean section to reduce bleeding in morbidly adherent placenta: a pilot study. Future Sci OA. 2022;F0789. doi:10.2144.fsoa-2021-0087