Uterine Cooling during Cesarean Section to Reduce Intraoperative Blood Loss: A randomized controlled trial

Abstract

Objectives: The aim was to compare uterine cooling and routine cesarean section as a means of reducing intraoperative blood loss. Materials and Methods: Pregnant women who underwent cesarean section at Khon Kaen Hospital between May and June, 2017 were randomly assigned to one of two groups: the uterine cooling (UC) group (n= 80) or the control group (n= 80). In the UC group, the uterus was wrapped using a sterile cooling swab while in the control group a routine cesarean section (CS) was performed. Results: In UC group, there was a statistically significant reduction in intra-operative blood loss compared with routine CS (252.8 ± 133.8 vs 472.9 ± 201.8 ml), mean difference 220 ml (95%CI 166.6-273.5). Uterotonic drugs use was significantly less in the UC group (1.3% vs 10%, p = 0.02). Length of hospital stay was significantly less in the UC group (3.0 ± 0.5 vs 3.2 ± 0.7 day; p = 0.01). There was no significant difference between the two groups in postpartum hemorrhage. There was no intraoperative hypothermia found. Conclusion: Uterine cooling was associated with a reduction in intraoperative blood loss among pregnant women undergoing cesarean section.

Keywords

• Uterine cooling
• cesarean section
• postpartum hemorrhage