Abstract
Purpose
To observe the hemostatic efficacy of reconstructing the lower uterine segment by wave compression sutures (WCSs) in patients with placenta previa who underwent cesarean section (CS).
Methods
Retrospective analysis the medical records with placenta previa underwent WCS at the West China Second University Hospital of Sichuan University.One-hundred-and-twenty-three women who received WCSs as the first uterine suture technique from January 1, 2016, to December 31, 2020, were included in this study. The hemostatic effect of WCS was compared according to the type of placenta previa and the intraoperative situation. All patients were followed up after CS.
Results
The hemostatic effect during CS and postpartum hemorrhage were observed. Seventy-two (58.5%) patients successfully achieved hemostasis without further intervention. Fifty-one (41.5%) cases required additional uterine artery ligation (UAL), cervical hanging maneuver (CHM), and Bakri tamponade. Seventy-nine cases exhibited thin anterior walls and lower uterine atony after placental dissection; of these, 72 (91.1%) obtained hemostasis by WCS. No patient required repeat laparotomy or hysterectomy. There were no complications attributable to the WCS following surgery. Among the five patients who had a second pregnancy, no intrauterine adhesions or abnormal uterine morphologies were caused by WCS. No ectopic or incision pregnancies occurred.
Conclusions
Reconstruction of the lower uterine segment by WCS is a suitable technique for patients with thin anterior walls and uterine atony of the lower uterine segment along with placenta previa. WCS is easy to perform, effective, and safe.
The Uterine Sandwich Method for Placenta Previa Accreta in Mullerian Anomaly: Combining the B-Lynch Compression Suture and an Intrauterine Gauze Tampon
