Publication:

A comparison of the effectiveness of Samarthram vacuum suction cannula with uterotonic drugs as primary management in cases of atonic PPH at tertiary care center: a randomized clinical trial

Background Atonic PPH is a leading cause of maternal mortality. The SR cannula offers a low-cost, practical alternative by creating negative intrauterine pressure that mimics natural uterine retraction. To compare effectiveness of SR vacuum suction cannula and with uterotonic drugs in cases of Atonic PPH.

Methods This prospective study at GMC Akola enrolled 100 women developing atonic PPH after AMTSL. Patients were randomized to SR cannula (n=50) or uterotonics (n=50). Group A: Cannula inserted up to fundus, negative suction at 650 mmHg for 10 min, repeated hourly 3 times. Group B: Uterotonics given as needed sequentially (Methergine → Carbetocin→Misoprostol→Carboprost) with 15-min interval. All patients were observed for bleeding, tone, vitals;

Results In Group A (SR cannula), bleeding stopped in 14 min in 6%. In Group B (uterotonics),in 6%, 52%, 30% and 12% respectively. Mean blood loss was 302.85±106.07ml in Group A vs 377.9±135.41ml in Group B.

Conclusions SR cannula is as effective as uterotonics for atonic PPH, with faster bleeding control, lower cost, reusability and transport feasibility, yet larger studies are needed for validation.