Role of Cervical Tamponade in Controlling Bleeding During Cesarean Section of Placenta

Abstract

Background: Placenta previa and placenta accreta spectrum are important causes of severe hemorrhage during cesarean delivery and remain associated with substantial maternal morbidity and mortality. Uterotonic agents, uterine packing, balloon tamponade, compression sutures, vascular ligation, arterial embolisation, and hysterectomy are examples of conventional management; however, these procedures may be unsuccessful, technically difficult, or linked to serious complications and infertility. A straightforward, conservative surgical method that makes advantage of the cervix as a natural compressive structure is cervical tamponade with cervical inversion. In order to compress the bleeding placental bed while preserving cervical canal patency, the cervical lip is pulled into the uterine cavity and sutured to the matching lower uterine segment. According to available clinical data, this method can quickly achieve haemostasis, minimise blood loss and the necessity for a hysterectomy, protect the uterus and future fertility, and enable direct bleeding point viewing and suturing. Therefore, for women with placenta previa or placenta accreta spectrum, cervical tamponade may be a practical and effective way to reduce heavy bleeding following caesarean surgery.