IMR Press / CEOG / Volume 50 / Issue 9 / DOI: 10.31083/j.ceog5009184
Open Access Original Research
Is Application of Uterine Fundus Pressure with a Sandbag Effective in Reduction of Cesarean Bleeding? A Prospective Case Control Study
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1 Department of Obstetrics and Gynecology, Firat University School of Medicine, 23270 Elazig, Turkey
2 Department of Obstetrics and Gynecology, Fethi Sekin Training and Research Hospital, 23270 Elazig, Turkey
3 Department of Obstetrics and Gynecology, Gazi Yaşargil Training and Research Hospital, University of Health Sciences, 21070 Diyarbakır, Turkey
4 Department of Emergency Medicine, Firat University School of Medicine, 23270 Elazig, Turkey
*Correspondence: sehmuspala@hotmail.com (Şehmus Pala)
Clin. Exp. Obstet. Gynecol. 2023, 50(9), 184; https://doi.org/10.31083/j.ceog5009184
Submitted: 31 May 2023 | Revised: 5 July 2023 | Accepted: 13 July 2023 | Published: 5 September 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Uterine compression methods reduce the amount of postpartum bleeding. In our study, we investigated the effect of fundal pressure, which will be created by a sandbag placed on the abdomen, on reducing post-cesarean bleeding. Methods: A total of 482 patients who delivered by cesarean section (CS) in the Obstetrics Clinic of Fırat University Faculty of Medicine between January 2021 and December 2021 were included in this prospective, randomized, single-center study. There were two groups: control group (n = 246), weighted group (n = 236). A sandbag weighing approximately 3 kg was used as a fundal compression tool. Hemoglobin (Hb) and hematocrit (Hct) concentrations and amount of vaginal bleeding were determined preoperatively and at the postoperative 8th and 24th hours. In addition, the time of milk coming from the breast and visual analogue scale (VAS) were evaluated. Results: The postoperative Hb value at 24 hours was significantly lower in weighted group compared to control group. The estimated amount of postoperative bleeding (based on the number of pads) was higher in weighted group compared to control group. The time to onset of milk production from the breast at the postoperative 8th hour was significantly longer in weighted group compared to control group. Postoperative VAS scores at 24 hours were significantly higher in weighted group compared to control group. Conclusions: Applying fundal pressure by using a sandbag from the abdominal route seems ineffective in reducing the amount of bleeding after CS. It may even increase the amount of bleeding. Clinical Trial Registration: The study was registered at https://clinicaltrials.gov/, registration number: NCT06005831.

Keywords
cesarean section
fundal pressure
postpartum hemorrhage
sandbag
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