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Research Article | Volume 13 Issue:3 (, 2023) | Pages 1280 - 1284
Paily’s Aortic occlusion clamp during caesarean hysterectomy for placenta accreta spectrum (PAS); a case series
Under a Creative Commons license
Open Access
DOI : 10.5083/ejcm
Published
Aug. 23, 2023
Abstract

Objectives- To study effectiveness of temporary aortic clamping as a method of limiting blood loss at  in women with placenta accrete spectrum Methods- Data was collected from records of  14 patients with PAS who had Paily’s aortic clamp applied after delivery of baby and prior to  Caesarean hysterectomy from January 2016 to  December 2021 at Government Medical College Hospital ,Thrissur,Kerala,India. Results- 6(42.9 %) cases were diagnosed intraoperatively.12 (85.7 %) had a Classical Caesarean and 2( 14.3 %) had a lower segment Caesarean followed by total hysterectomy. Mean duration of application of the clamp was 28.21±12.49 min(Range 15-60 min).The mean blood loss was 1.77 ± 0.96 litres(95% CI 1.21-2.33 ).Mean units of blood transfused was 2.64 (95 % CI 1.67-3.62).None of the patients required ionotropes or critical care. There were 2 cases(14.2 %) of bladder injury ,both occurred in FIGO type 3b PAS.There were no cases of  vascular injury,organischemia,thrombosis or relaparotomy for bleeding.Mean duration of hospital stay was 11.35 ± 5.38 days. Conclusion- Aortic clamping prior to Caesarean hysterectomy is a safe and  effective  method to reduce blood loss in Placenta Accreta Spectrum.

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