In the past two years, doctors from Mumbai’s state-run Sir JJ Group of Hospitals have managed to save uterus of 52 pregnant women.
According to the doctors, these women were suffering from placenta praevia, a condition when the placenta attaches inside the uterus, but near or under the cervical opening.
The complications include dangerously low blood pressure, bleeding during and after delivery.
Usually, one in 200 women suffers from this condition, but, the cases are rising due to more number of Caesarean sections being done.
In almost all the cases, when woman has placenta praevia which is morbidly adherent it is a very complicated condition.
Hysterectomy is required in morbidly adherent placenta praevia. Blood loss can be even more than 2.5 liter .With this stitch it is less than 250ml.
While speaking to My Medical Mantra, Dr Ashok Anand, Head of Gynaecology Department of Sir JJ Group of Hospitals, said, “Placenta praevia is a very complicated condition. Earlier, one or two women used to suffer from this. But now, due to a high incidence of C-sections, the number of pregnant women are suffering from this is increasing. In our hospital, we witness two to three cases every month. In this case, the placenta, which connects the baby to the mother, is attached to the cervical opening. During the delivery, around 1.5 litres of blood loss can happen, which can be fatal as well.”
Dr Anand further said, “If a woman is suffering from placenta praevia, after delivery, the doctor removes the uterus. By doing this, we can prevent heavy blood loss, but, the woman can never conceive a child again. So, in 2007, we started doing a small procedure, where we give stitches to the vagina and save the uterus. It is a 10-minute procedure, but with this, we have managed to save the uteruses of as many as 52 women.”
What is placenta praevia?
A condition when the placenta attaches inside the uterus, but near or under the cervical opening.
Its symptoms include vaginal bleeding during the second half of the pregnancy.
Bleeding is bright red and not linked with pain.
“Unwanted C-sections and repeated deliveries are the major contributing factors behind developing the Placenta Praevia,” informed Dr Ashok Anand.
Smita Wadkar (name change) works as a nurse in Mumbai’s state-run Sir JJ Groups of Hospital. Smita was experiencing a blood loss during her pregnancy. She was diagnosed with placenta praevia when she was 24 weeks pregnant. After the C-section, the doctors had put stitches and saved her uterus.
Placenta praevia can happen due to:
- Repeated deliveries
- Unwanted C-section delivery
- Heavy smoking habit
- Age more than 35 during pregnancy
What is Ashok Anand Stitch for placenta praevia?
- Once baby is delivered in case of placenta praevia
- Compress the placenta with a mop so that placenta does not get separated and bleed.
- Exterise the uterus.
- Occlude bilateral descending cervical artery.
- Push the bladder down below the cervix if it is not done before the uterine incision.
- Use straight needle as lower segment is thick do to placenta praevia. The same needle is then reinserted from posterior to anterior
- Just below the uterine incision .
- And then the stitch is tied. Same thing is repeated on the other side
- Then the placenta can be removed. You can remove placenta even if it is morbidly adherent.
Dr Ashok Anand’s uterus saving procedure has been published in the International Journal as well. Dr Anand was invited to talk about this procedure at an international conference in China as well.