A modified suture technique for hemorrhage during cesarean delivery complicated by complete placenta previa

Int J Gynaecol Obstet. 2015 Apr;129(1):26-9. doi: 10.1016/j.ijgo.2014.11.005. Epub 2015 Jan 6.

Abstract

Objective: To assess the usefulness of a modified suture to treat postpartum bleeding among patients with complete placenta previa (CPP).

Methods: An observational study was conducted at Beijing Chaoyang Hospital, Beijing, China, among patients with CPP (with or without placenta accreta) who were enrolled from January 1 to March 31, 2014. During surgery, a Foley catheter balloon containing 60-120 mL of water was used to compress the hemorrhage site and an absorbable suture was placed around the lower uterus segment to provide extra pressure on the balloon.

Results: Seven women with CPP underwent the procedure. The median hemostatic time was 4.6 minutes (range 3.0-7.0). The median estimated blood loss during surgery was 480 mL (range 400-600) for deliveries not complicated with placenta accreta and 1250 mL (range 1000-1500) for women with placenta accreta. Active bleeding was stopped after application of the modified suture; blood loss was less than 100mL in all cases in the 24 hours after surgery.

Conclusion: The modified suture technique provided an easy and efficient surgical choice for women with CPP, especially among those with placenta accreta.

Keywords: Cesarean delivery; Complete placenta previa; Foley catheter; Lu suture; Placenta accreta; Postpartum hemorrhage.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Beijing
  • Blood Loss, Surgical / statistics & numerical data
  • Cesarean Section / methods*
  • Female
  • Humans
  • Placenta Accreta / surgery*
  • Placenta Previa / surgery*
  • Postpartum Hemorrhage / surgery*
  • Pregnancy
  • Suture Techniques*