Use of cervical inversion technique as a tamponade to control postpartum hemorrhage caused by placenta previa and placenta previa focal accreta

Aim of the work: To assess the efficacy of cervical inversion as a tamponade in controlling placental bed bleeding in cases of placenta previa and accreta.
Patients and Methods: After approval of ethics committee, a descriptive prospective study was conducted among a total of 40 female pregnant women (20 with placenta previa and 20 focal accreta) who attended the inpatient clinic of Obstetrics and Gynecology Department at Suez Canal University Hospital over a period of one year from April 2016 to April 2017. Preoperative assessment via history taking and clinical examination as used per hospital standard protocol with an assessment of hemodynamic stability was performed. Patients were evaluated for time needed for the technique, blood loss and postoperative hospital stay. Six weeks postoperative, follow up assessment of position of cervix by speculum examination was performed.
Results: Mean age of patients was 29.2 years old. Mean time required for technique was 8 minutes and was longer with placenta accreta. Mean intraoperative blood loss was 1340.95 ml with significantly more blood loss with placenta accreta. Speculum examination six weeks postoperatively revealed normal position and normal morphology of the cervix in 32 cases (80%).
Conclusion: Cervical inversion as a tamponade is apparently safe, simple, rapid and potentially effective easy to perform procedure.