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

摘要

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 100 mL 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. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.