{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T22:53:02Z","timestamp":1781736782641,"version":"3.54.5"},"reference-count":6,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality, with cesarean delivery posing a heightened risk. While interventions such as prophylactic tranexamic acid and balloon tamponade have limitations\u2014especially when the cervix is not dilated\u2014vacuum-assisted uterine tamponade may offer a novel intraoperative approach. This prospective pilot study evaluated the feasibility of the Daisy catheter, a cervical drain device developed by Raydiant Oximetry, Inc., designed to evacuate blood and promote uterine contraction through continuous negative-pressure suction.<\/jats:p>\n                  <jats:p>We enrolled ten pregnant individuals scheduled for cesarean delivery at a tertiary care center, all of whom had at least one PPH risk factor. Following fetal and placental delivery, the Daisy catheter was inserted trans-hysterotomically, advanced through the cervix, and connected to wall suction (\u221290 to \u2212100\u2009mm Hg) for 2\u2009hours. Quantitative blood loss, perioperative hemoglobin change, ultrasound findings, and adverse events were recorded.<\/jats:p>\n                  <jats:p>Device placement succeeded in 9 of 10 cases; one failure was due to an undiagnosed cervical cerclage. Eight participants completed the full suction protocol. Mean hemoglobin decline from preoperative baseline to postoperative day 1 was 1.36\u2009\u00b1\u20090.47\u2009g\/dL, significantly lower than the 1.9\u2009\u00b1\u20091.1\u2009g\/dL observed in a historical cohort from 31 U.S. hospitals (p\u2009=\u20090.019). Ultrasound at 2\u2009hours postpartum confirmed correct device placement, absence of intrauterine clot, and no evidence of trauma. Device removal was uncomplicated, and no adverse events were reported.<\/jats:p>\n                  <jats:p>These preliminary findings suggest that intraoperative use of the Daisy device is feasible, well-tolerated, and may reduce blood loss after cesarean delivery. Larger, randomized trials are warranted to evaluate its impact on transfusion rates, reoperation, and overall maternal outcomes, particularly in settings where alternative tamponade methods are limited. The ClinicalTrials.gov identifier is NCT06219538.<\/jats:p>","DOI":"10.1055\/a-2752-8798","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:13:12Z","timestamp":1764029592000},"page":"1253-1255","source":"Crossref","is-referenced-by-count":0,"title":["A Uterine Suction Device to Prevent Postpartum Hemorrhage in Scheduled Cesarean Delivery: A Pilot Study"],"prefix":"10.1055","volume":"43","clinical-trial-number":[{"clinical-trial-number":"nct06219538","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-1699","authenticated-orcid":false,"given":"Tetsuya","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University, Norfolk, Virginia, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Ray","sequence":"additional","affiliation":[{"name":"Raydiant Oximetry, San Ramon, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Brennan","sequence":"additional","affiliation":[{"name":"Raydiant Oximetry, San Ramon, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Rosen","sequence":"additional","affiliation":[{"name":"Raydiant Oximetry, San Ramon, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Saade","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University, Norfolk, Virginia, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"issue":"02","key":"ref2","first-page":"e0263701","article-title":"Risk of postpartum hemorrhage in women undergoing cesarean section versus vaginal delivery: a systematic review and meta-analysis","volume":"17","author":"H Schr\u00f6der","year":"2022","journal-title":"PLoS One"},{"issue":"05","key":"ref3","first-page":"463.e1","article-title":"Postpartum hemorrhage in the United States: epidemiology and risk factors","volume":"217","author":"A J Butwick","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"17","key":"ref4","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1056\/NEJMoa2028788","article-title":"Tranexamic acid for the prevention of blood loss after cesarean delivery","volume":"384","author":"L Sentilhes","year":"2021","journal-title":"N Engl J Med"},{"issue":"08","key":"ref5","first-page":"693","article-title":"Tranexamic acid to prevent obstetrical hemorrhage after cesarean delivery","volume":"387","author":"L D Pacheco","year":"2022","journal-title":"N Engl J Med"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"S1076","DOI":"10.1016\/j.ajog.2023.08.015","article-title":"Intrauterine devices in the management of postpartum hemorrhage","volume":"230","author":"E Overton","year":"2024","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"e168","DOI":"10.1097\/AOG.0000000000002351","article-title":"Practice bulletin no. 183: postpartum hemorrhage","volume":"130","author":"Committee on Practice Bulletins-Obstetrics","year":"2017","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2752-8798.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T22:40:45Z","timestamp":1781736045000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2752-8798"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":6,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2026,6,17]]},"published-print":{"date-parts":[[2026,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2752-8798","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,11,24]]},"published":{"date-parts":[[2025,11,24]]}}}