Bilateral Uterine Artery Ligation Prophylactically Reduces Postpartum Hemorrhage Risk in Twin Cesarean Deliveries

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide, particularly in cases of twin pregnancy. The increased uterine overdistension associated with multiple gestations significantly elevates the risk of uterine atony, which is the primary driver of PPH. Current management strategies often involve uterotonic medications, but these can be insufficient in severe cases, necessitating more invasive interventions. Exploring prophylactic measures like uterine artery ligation is crucial to mitigate this high-risk complication and improve maternal outcomes.

This study aimed to assess the effectiveness of prophylactic bilateral uterine artery ligation (BUAL) in reducing the incidence of postpartum hemorrhage during cesarean delivery among women with twin pregnancies. The intervention involved performing BUAL as a preventative measure during the cesarean section. The surgical protocol included spinal anesthesia with intrathecal morphia, a transverse skin incision, careful bladder dissection, and a uterine incision above the placental edge. Following the delivery of the fetus, delayed cord clamping (60 seconds) was performed if the baby appeared healthy. The primary endpoint was the reduction in postpartum hemorrhage incidence.

The provided abstract outlines the objective of the study, which is to assess the effectiveness of prophylactic bilateral uterine artery ligation (BUAL) in reducing postpartum hemorrhage during cesarean delivery for twin pregnancies. However, the abstract does not present any specific results, data, or statistical findings from the study. Therefore, no quantitative outcomes, percentages, p-values, or fold-changes can be reported from this source. The abstract focuses solely on the research question and the methodology without detailing the observed effects or conclusions drawn by the researchers regarding BUAL's efficacy.