title: Reduced blood loss during caesarean section due to a controlled stapling technique.
abstract: Blood loss during Caesarean section is mainly due to the hysterotomy. A new technique to reduce this blood loss has been evaluated in a prospective controlled clinical trial in 89 patients. The operation technique was standardized according to Joel-Cohen. In the control group (n = 45) the low transversal incision was enlarged by scissors in an upward swing, in the staple group (n = 44) the incision was enlarged by introducing the poly CS 57 instrument with absorbable staples. A double row of staples sealed blood vessels and secured the three uterine layers just before the instrument's blade cut the uterine wall. The two groups were comparable as to the indications for the CS, first or repeat CS, primary or secondary CS, maternal age and parity. The duration of the operation, postoperative complications and hospital stay was equal. However, the blood loss in the 'staple' group was significantly less than in the control group. The conclusions are that this new technique reduced blood loss during Caesarean section, and moreover, it appeared to be extremely useful in patients with varicose veins in the lower uterine segment or placenta praevia.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Nijmegen, The Netherlands.
authors.forename: P W
authors.initials: PW
authors.lastname: van Dongen
authors.forename: J G
authors.initials: JG
authors.lastname: Nijhuis
authors.forename: H W
authors.initials: HW
authors.lastname: Jongsma
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D002986:Clinical Trials as Topic; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D013528:Surgical Staplers; D014592:Uterine Hemorrhage / Q000209:etiology* / Q000517:prevention & control