Uterine Cooling During Cesarean Section an Attempt to Reduce Blood Loss and Atonic Post-Partum Hemorrhage

Objective: Evaluation of the effect of uterine cooling during caesarean section on both, amount of blood loss and incidence of uterine atony. Method: This prospective randomized controlled study was conducted at Mansoura University Hospital, Obstetrics and Gynecology Department in the period from June 2017 to June 2018, included 220 patients who underwent delivery by caesarean section. All women included in the study were randomized into two equal groups; half of these patients were randomly assigned to uterine cooling after delivery of the fetus and placenta using cold saline. The other half of these patients, caesarean section was done in the usual manner. The amounts of blood loss were calculated for all patients during and after caesarean section. Also the occurrences of uterine atony were noticed on both groups. Data was regestrated for statistical analyses. Results: There were no significant difference between both groups as regard of age, gravidity, parity, gestational age, no of previous caesarean section, preoperative hemoglobin level and hematocrit values . The total amounts of blood loss during and after caesarean section was significantly low in cooling group P value (<0.001). Although atonic postpartum hemorrhage was lower in cooling group (3 cases 2.7 %) versus (10 cases 9.1%) in non-cooling group, it was not statistically significant P value (0.53). Conclusions: Uterine cooling by iced saline decrease total blood loss and decrease incidence of atonic PPH.