Manual strangulation of the uterine isthmus after placental removal to reduce blood loss during cesarean section.

<bold>Introduction: </bold>This study aimed to evaluate the effect of manual strangulation of the uterine isthmus on the amount of blood loss during cesarean section.<bold>Material and Methods: </bold>This is a prospective randomized controlled trial. A total of 118 participants were enrolled in the study. Manual strangulation of the uterine isthmus just after placental removal was performed during cesarean section in group I (n = 57; the strangulation group). Strangulation was not performed in group II (n = 61; the control group). Preoperative and postoperative venous blood hemoglobin, capillary hemoglobin, and absorbed blood levels during the operation were compared between the two groups.<bold>Results: </bold>The median age of the patients was 28.5 (19-41). The median body mass index of the patients in the study was 27 (21-42). There were no significant differences in the demographic characteristics of the patients between the groups. The median difference between the preoperative and postoperative 4-6 h capillary hemoglobin values was significantly lower in the strangulation group (2.0 (0-9)) than in the control group (3.0 (0-8)). The amount of absorbed blood during the operation was also significantly lower in the strangulation group (164.5 ml (69-1310)) than in the control group (230 ml (35-3223)).<bold>Conclusions: </bold>Manual uterine strangulation of the uterine isthmus immediately after the removal of the placenta may induce a 30% decrease in blood loss during cesarean section. [ABSTRACT FROM AUTHOR]