Evaluating the efficacy of metal suction cannula for atonic postpartum haemorrhage management in rural south Gujarat: a two-year observational study

Authors

  • Ritika Shrivastav Department of Obstetrics and Gynaecology, Shreeji hospital, Gujarat, India
  • Rekha Shrivastava Department of Obstetrics and Gynaecology, Shreeji hospital, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20241076

Keywords:

PPH, Suction cannula, Negative pressure

Abstract

Background: In resource-constrained regions characterized by limited healthcare infrastructure, low female literacy rates, and constrained access to medical resources, postpartum hemorrhage (PPH) remains a dire obstetric emergency. This research article investigates the effectiveness of metal suction cannula as a simple, safe and cost-effective technique for atonic PPH management in a private hospital in Rural South Gujarat. The primary aim of this study was to examine the effectiveness of the metal suction cannula in managing atonic PPH and the maternal outcome after suction technique.

Methods: This observational study was conducted in Shreeji hospital, a private multifacility hospital in rural south Gujarat over the period of two years, between June 2021-May 2023 and involved 148 patients who were admitted for labour and delivery but later developed atonic PPH after AMTSL. Metal cannula and high vacuum suction machine was used. Data like patient demographics, risk factors, and post-procedural outcomes were studied.

Results: Following application of the metal vacuum cannula technique, bleeding stopped within five minutes in 78 women (52.7%). For 53 women (35.8%), bleeding ceased between 5-10 minutes. In 17 women (11.4%), bleeding was effectively halted after more than ten minutes. In 87 women (58.8%), negative pressure was applied only once, resulting in successful hemorrhage control. 38 women (25.6%) required suction application two times and 25 women (20.8%) needed three applications of negative pressure to effectively stop the bleeding. The volume of blood collected in the bottle after metal vacuum cannula application ranged from 100 to 300 ml.

Conclusions: Factors such as ease of use, affordability, and improved clinical outcomes make suction cannulas an effective tool in the management of PPH in resource limited areas. It requires minimal training, conserves the uterus, is technically less challenging and reduces the requirement of blood and blood products.

References

Meh C, Sharma A, Ram U, Fadel S, Correa N, Snelgrove JW, et al. Trends in maternal mortality in India over two decades in nationally representative surveys. BJOG. 2022;129(4):550-61.

Ozimek JA, Kilpatrick SJ. Maternal mortality in the twenty-first century. Obstet Gynecol Clin North Am. 2018;45(2):175-86.

Rathore AM, Gupta S, Manaktala U, Gupta S, Dubey C, Khan M. Uterine tamponade using condom catheter balloon in the management of non-traumatic postpartum hemorrhage. J Obstet Gynaecol Res. 2012;38(9):1162-7.

Snelgrove JW. Postpartum haemorrhage in the developing world a review of clinical management strategies. Mcgill J Med. 2009;12:61.

American College of Obstetricians and Gynecologists. Clinical Management Guidelines for Obstetrician Gynecologists. Prophylactic Antibiotics in Labor and Delivery. Obstet Gynecol. 2003;102(4):875-82.

Dildy GA, Paine AR, George NC, Velasco C. Estimating blood loss: can teaching significantly improve visual estimation? Obstet Gynecol. 2004;104(3):601-6.

Bienstock JL, Eke AC, Hueppchen NA. Postpartum hemorrhage. N Engl J Med. 2021;384(17):1635-45.

Zheutlin AB, Vieira L, Shewcraft RA, Li S, Wang Z, Schadt E, et al. A comprehensive digital phenotype for postpartum hemorrhage. J Am Med Inform Assoc. 2022;29(2):321-8.

Wang D, Xu S, Qiu X, Zhu C, Li Z, Wang Z, et al. Early usage of Bakri postpartum balloon in the management of postpartum hemorrhage: a large prospective, observational multicenter clinical study in South China. J Perinat Med. 2018;46(6):649-56.

WHO recommendations for the prevention of postpartum haemorrhage. 2007. Available at: http://whqlibdoc.who.int/. Accessed on 12 February, 2024.

WHO recommendations: intrapartum care for a positive childbirth experience. 2022. Available at: https://www.who.int/publications-detail-redirect/9789241550215. Accessed on 12 February, 2024.

Samartha Ram H, Shankar Ram HS, Sandhya Ram S, Panicker V. Vacuum retraction of uterus for the management of atonic postpartum hemorrhage. J Dent Med Sci. 2014;13(11):15-9.

Panicker TN. Panicker's vacuum suction haemostatic device for treating post-partum haemorrhage. J Obstet Gynaecol India. 2017;67(2):150-1.

Damor P, Maheshwari S, Singh S. Role of SR vacuum cannula as novel technique for atonic postpartum hemorrhage management study at Pannadhay Rajkiya Mahila Chikitsalaya and RNT Medical College, Udaipur. Int J Reprod Contracept Obstet Gynecol. 2021;10(11):4150-53.

Meena M, Meena P. A clinical study of the use of SR vaccum suction cannula in the management of atonic pph at tertiary care hospital. Int J Sci Res. 2020;9(1):1812-5.

Downloads

Published

2024-04-26

Issue

Section

Original Research Articles