management of abnormal lower uterine segment after fetal delivery in cesarean section

This study is testing a surgical technique — multiple transverse compression sutures including the uterine artery — to control heavy bleeding from the lower part of the uterus during caesarean section in high-risk cases. This includes situations where the placenta is covering the cervix (placenta previa), abnormally attached (placenta accreta), or where the lower uterine wall is dangerously thin. The goal is to avoid the need for a hysterectomy by controlling bleeding with this suturing method. You may be eligible if: - You are a woman 18 years of age or older - You are undergoing caesarean section and have one of: a ballooned and bleeding lower uterine segment from placenta previa, placenta accreta, or a thinned lower uterine segment You may NOT be eligible if: - You have placenta percreta (placenta growing through the uterine wall) - You are haemodynamically unstable (in shock from blood loss) Talk to your doctor about whether this trial might be right for you.