Foley Catheter as a Tourniquet for Hemorrhage Prevention during Peripartum Hysterectomy in Patients with Placenta Accreta Spectrum (PAS)-A Hospital-Based Study.

BACKGROUND: Placenta accreta spectrum (PAS) is a clinical entity significantly increasing the risk of a peripartum hemorrhage. Various surgical methods have been described in the literature, which aim to reduce the risk of bleeding, although they often lack reproducibility and have been performed on low numbers of patients. The aim of this study was to evaluate the use of the Foley catheter as a cervical tourniquet during cesarean sections, in patients with PAS. METHODS: All patients who underwent peripartum hysterectomy due to PAS in a large single-center registry were included in the present analysis. The general demographics and clinical characteristics of all participants, including blood loss, and maternal and fetal outcomes, were collected and analyzed. RESULTS: Twelve participants were included. The mean blood loss was 1200 ± 760 ml during operation and the mean ± SD procedural duration was 89 ± 17 min. The median (Q1-Q3) length of hospital stay post-procedurally was 5 (4-6) days. None of the patients required subsequent urgent surgical procedures after hysterectomy. The median (Q1-Q3) packed red blood cell units transfused in our cohort was 2 (0-3). CONCLUSION: Using the Foley catheter as a tourniquet might be an effective method of excessive bleeding prevention in patients with PAS during peripartum hysterectomy.

Foley Catheter as a Tourniquet for Peripartum Hemorrhage Prevention in Patients with Placenta Accreta Spectrum-A Two Case Report and a Review of the Literature.

One of the most perilous complications in obstetrics, often leading to severe bleeding and sometimes a need for urgent hysterectomy, is placenta accreta spectrum, which significantly increases the risk of peri-partum complications, even including the risk of death for the mother and the child. Dealing with excessive bleeding in this situation is paramount. We have found a Foley catheter tourniquet to be useful as a temporary tourniquet to control placental and uterine hemorrhage. We have used this method and find it very useful. In this publication, we describe the last two cases of the use of the Foley catheter as a tourniquet for peri-partum hemorrhage prevention, and we will present a review of the literature in this field.

Recommendations of the Polish Society of Gynaecologists and Obstetricians for removal of the uterus by vaginal, laparoscopic and abdominal routes.

The recommendations represent the current procedure, which may be modified and changed where justified, after a thorough analysis of the given clinical situation, which may be the basis for their modification and updating in the future.