Background: Caesarean section is a common operation in obstetrics which is regarded generally safe but can be associated with significant morbidity. We aimed to compare successful usage of topical oxidized regenerated cellulose versus Gelfoam in a case of uterine incision hemorrhage at
time of caesarean section refractory to traditional treatment.
Methods: We performed a prospective randomized open label clinical trial on 60 who underwent cesarean delivery and had intraoperative bleeding aged >18 years old. Patients were randomly divided in two equal groups. Group I were managed by oxidized regenerated cellulose and group II were managed by Gelfoam. All patients were subjected to demographic data, history of comorbidities, laboratory assessment. In both groups, the placenta was delivered by controlled cord traction. The uterus was closed with a single layer polyglactin (vicryl) suture Results: Blood loss of 500 cc or more occurred in 9 (30%) patients in group I and 17 (56.67%) patients in group II. 6 (20%) patients in group I and 12 (40%) patients in group II needed blood transfusion. Blood loss of 500 cc or more and need for blood transfusion was lower in group I compared to group II with no statistically significant difference between both groups. Conclusion: Local hemostatic agents; oxidized regenerated cellulose and gel foam was useful in adjuvant in control of postpartum bleeding in cesarean section. Oxidized regenerated cellulose use was associated with an increased incidence of post-operative fever significantly higher post- operative Hb levels compared to gelfoam. |
