Mostafa Maged Technique to Control and Prevent the Post-Partum Bleeding From the Lower Uterine Segment in Placenta Previa Cases

Post - partum haemorrhage is still a headache to all obstetricians around the whole world . Every obstetrician exerts his own full effort to control bleeding which can occur post-partum by applying all maneuvers to preserve the fertility and the uterus for the patient .

demonstration of ( Mostafa Maged ) technique is applied to control and prevent post-partum haemorrhage . It is so simple maneuver and easy to be applied within short period of time .Satisfactory hemostasis can be assessed after application .

Study Overview

• Status: Completed
• Conditions: Placenta Previa
• Intervention / Treatment: Procedure: Mostafa Maged Technique

Detailed Description

1. pfannestiel incision .
2. dissection of the bladder downwards , and then making an incision in the lower segment of the uterus , then the uterus is evacuated from the fetus and placenta .
3. Ligation of the uterine arteries on both sides is applied before proceeding and after the extraction of fetus and placenta .

5) The lower segment was bleeding so trying to do bimanual compression of the anterior and posterior parts of lower uterine segments to test if Mostafa Maged technique is useful in these cases or not (( by observing if the bleeding is minimized or stopped or not by compression )) as if it is minimized so our technique has a high chance to be effective .

6) The whole technique depends on the anterior lower uterine segment by dividing the anterior lower uterine segment by an imaginary line in two halves , then , turning over (flipping ) the upper part of the lower uterine segment onto the lower part of the lower uterine segment from the inside of uterine cavity .

7) doing this turnover (flipping ) by the hands and holding the imaginary line by two Allis forceps and by making three knots by three needles in the lower edge of the uterine incision and entering the needles of (absorbable 70 mm rounded-bodied vicryl 1 ) simultaneously into the lower segment through the uterine cavity , at the same level of , the inside wall of lower uterine segment in order to drag the upper (half) part of the lower uterine segment on the lower part of lower uterine segment ( sandwich - like ) , and after this maneuver the bleeding is re-evaluated again .

8) Third , stitching the both sides of the flipped lower uterine segment by ( absorbable 70 mm rounded-bodied vicryl 1 ) , then doing plication of the anterior lower uterine segments to strengthen the wall of the flipped lower uterine segment and secure the tension .

9) Fourth , closing the caeserian scar by suturing the already-flipped lower uterine segment onto the upper uterine segment .

10) placing a drain in the doglus pouch

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Fayoum, Egypt, 0020
    • Fayoum general hospital and Fayoum university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 30 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• pregnant primigravida patients with placenta previa
• 18 to 30 years old

Exclusion Criteria:

• patients with bleeding disorders
• smokers
• morbid obese patients

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: The Mostafa Maged technique to prevent and control post-partum bleeding in placenta previa cases; primigravida patients with placenta previa conditions and their ages between ( 18 - 30 ) years old

Procedure: Mostafa Maged Technique; pfannestiel incision . dissection of the bladder downwards , and Ligation of the uterine arteries on both sides then , we turn over the upper part of the lower uterine segment onto the lower part of the lower uterine segment from the inside of uterine cavity .We do this turnover (flipping ) by our hands and holding the imaginary line by two Allis forceps and by making three knots by three needles in the lower edge of the uterine incision and we enter the needles of simultaneously into the lower segment through the uterine cavity , at the same level of , the inside wall of lower uterine segment to drag the upper (half) part of the lower uterine segment on the lower part of lower uterine segment ( sandwich - like ) Third , we stitch the both sides of the flipped lower uterine segment , then we do plication of the anterior lower uterine segments to strengthen the wall of the flipped lower uterine segment and place a drain in the doglus pouch

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
primary post-partum bleeding	prevention and management of bleeding from lower segment ....estimation of number of pads used during section to estimate blood loss ... and to assess the number of blood loss postpartum roughly visually	twenty-four hours post-partum

Collaborators and Investigators

• Sponsor: Fayoum University

Study record dates

Study Major Dates

• Study Start (Actual): March 24, 2022
• Primary Completion (Actual): May 20, 2022
• Study Completion (Actual): May 20, 2022

Study Registration Dates

• First Submitted: March 8, 2022
• First Submitted That Met QC Criteria: March 8, 2022
• First Posted (Actual): March 16, 2022

Study Record Updates

• Last Update Posted (Actual): August 1, 2022
• Last Update Submitted That Met QC Criteria: July 27, 2022
• Last Verified: July 1, 2022

More Information

Terms related to this study

• Keywords: lower uterine segment; placenta previa; Mostafa Maged technique; caeserian section
• Additional Relevant MeSH Terms: Pathologic Processes; Hemorrhage; Pregnancy Complications; Obstetric Labor Complications; Placenta Diseases; Puerperal Disorders; Uterine Hemorrhage; Postpartum Hemorrhage; Placenta Previa
• Other Study ID Numbers: R 207

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No