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DOI: 10.1055/a-2313-0948
Lower Uterine Segment Corrugated Sutures in Hemorrhage during Cesarean Section because Previal and/or Placenta Accreta Spectrum: Case Reports Series and Literature Review
Abstract
Objectives We present the original technique of compression hemostatic sutures on the lower uterine segment due to early postpartum hemorrhage during cesarean section, with a literature review.
Methods A retrospective clinical case study was conducted at the tertiary perinatal center. Twelve patients had nine planned and three urgent cesarean sections due to antenatally verified placenta previa and/or placenta accreta spectrum and defined early postpartum hemorrhage > 1000 mL during cesarean section. As the use of uterotonics failed to produce any effect and hemorrhage persisted, compression sutures of the lower uterine segment were made by our own technique, as follows: below the hysterotomy, a horizontal corrugated suture is placed from the right to the left corner and after 2–3 cm vertically and backwards at several sites from the left to the right corner, where it is tightened.
Results Seven patients had one cesarean section, three patients had two cesarean sections, and seven patients had pregnancy from the in vitro fertilization procedure in their history. There were six patients with placenta previa and six patients with anterior invasive placenta accreta or increta. Original hemostatic procedure was applied successfully in ten cases, and after placement of O'Leary suture and persistent bleeding in two cases. In this group, no hysterectomy was performed, and patients received blood transfusion of 440–880 mL. Three patients later had spontaneous pregnancies.
Conclusion Our own hemostatic method with a simple technique, fast learning, and minimal logistics contributes to successful management of this currently global problem of morbidly adherent placenta previa.
Keywords
cesarean section - placenta praevia - placenta sccreta spectrum - hemostatic sutures - postpartum hemorrhagePublikationsverlauf
Eingereicht: 12. August 2023
Angenommen: 11. April 2024
Artikel online veröffentlicht:
03. Juni 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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References
- 1 Dildy GA. Postpartum hemorrhage: new management options. Clin Obstet Gynecol 2002; 45: 330-344
- 2 Boerma T, Ronsmans C, Melesse DY. et al. Global epidemiology of use of and disparities in caesarean sections. Lancet 2018; 392: 1341-1348
- 3 Rosen T. Placenta accreta and cesarean scar pregnancy: overlooked costs of the rising cesarean section rate. Clin Perinatol 2008; 35: 519-529
- 4 Rorie DK, Newton M. Histologic and chemical studies of the smooth muscle in the human cervix and uterus. Am J Obstet Gynecol 1967; 99: 466-469
- 5 Nott JP, Bonney EA, Pickering JD. et al. The structure and function of the cervix during pregnancy. Translat Res Anat 2016; 2: 1-7
- 6 El-Hamamy E, Wright A, B-Lynch C. The B-Lynch suture technique for postpartum haemorrhage: a decade of experience and outcome. J Obstet Gynaecol 2009; 29: 278-283
- 7 Steer PJ. The Hayman uterine compression suture. BJOG 2015; 122: 1137
- 8 Henrich W, Surbek D, Kainer F. et al. Diagnosis and treatment of peripartum bleeding. J Perinat Med 2008; 36: 467-478
- 9 Cho JH, Jun HS, Lee CN. Hemostatic suturing technique for uterine bleeding during cesarean delivery. Obstet Gynecol 2000; 96: 129-131
- 10 Meng Y, Wu P, Deng D. et al. Multifaceted spiral suture: A hemostatic technique in managing placenta praevia or accrete: A retrospective study. Medicine (Baltimore) 2017; 96: e9101
- 11 Ratiu AC, Crisan DC. A prospective evaluation and management of different types of placenta praevia using parallel vertical compression suture to preserve uterus. Medicine (Baltimore) 2018; 97: e13253
- 12 Xia L, Lin J, Dai Y. et al. Study on the application of King's combined uterine suture for hemostasis during cesarean section. BMC Pregnancy Childbirth 2021; 21: 762
- 13 Penotti M, Vercellini P, Bolis G. et al. Compressive suture of the lower uterine segment for the treatment of postpartum hemorrhage due to complete placenta previa: a preliminary study. Gynecol Obstet Invest 2012; 73: 314-320
- 14 Takahashi M, Takeda J, Haneda S. et al. “Step-by-step” minimally invasive hemostatic technique using intrauterine double-balloon tamponade combined with uterine isthmus vertical compression suture for the control of placenta accreta and severe atonic hemorrhage during a cesarean section. Surg J (N Y) 2021; 7: e216-e221
- 15 Zhao B, Lv M, Dong T. et al. Transverse parallel compression suture: a new suturing method for successful treating pernicious placenta previa during cesarean section. Arch Gynecol Obstet 2020; 301: 465-472
- 16 Çalışkan E, Akar B, Ceylan Y. et al. A novel low uterine segment sandwich technique (Caliskan's technique) for the management of post-cesarean hemorrhage due to placenta previa accreta. Turk J Obstet Gynecol 2021; 18: 79-84
- 17 Li GT, Li XF, Liu YJ. et al. Symbol “&” suture to control atonic postpartum hemorrhage with placenta previa accreta. Arch Gynecol Obstet 2015; 291: 305-310
- 18 Saad AF, Kirsch N, Saade GR. et al. Progressive devascularization: A novel surgical approach for placenta previa. AJP Rep 2018; 8: e223-e226
- 19 Schlembach D, Helmer H, Henrich W. et al. Peripartum haemorrhage, diagnosis and therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016). Geburtshilfe Frauenheilkd 2018; 78: 382-399
- 20 Habek D, Kulas T, Bobić-Vuković M. et al. Successful of the B-Lynch compression suture in the management of massive postpartum hemorrhage: case reports and review. Arch Gynecol Obstet 2006; 273: 307-309
- 21 Habek D. Transvaginal perpendicular cervical waveforms sutures in treatment of early postpartum hemorrhage caused by lower uterine segment atony. Taiw J Obstet Gynecol 2021; 60: 577-578
- 22 Habek D, Marton I, Prka M. et al. Transvaginally surgically treatment of early postpartum hemorrhage caused by lower uterine segment atony. J Perinat Med 2022; 50: 933-935
- 23 O’Leary JL, O’Leary JA. Uterine artery ligation for control of postcesarean section hemorrhage. Obstet Gynecol 1974; 43: 849-853
- 24 O'Leary JA. Uterine artery ligation in the control of postcesarean hemorrhage. J Reprod Med 1995; 40: 189-193
- 25 Liu X, Wang Y, Wu Y. et al. What we know about placenta accreta spectrum (PAS). Eur J Obstet Gynecol Reprod Biol 2021; 259: 81-89
- 26 Palacios Jaraquemada JM, Pesaresi M, Nassif JC. et al. Anterior placenta percreta: surgical approach, hemostasis and uterine repair. Acta Obstet Gynecol Scand 2004; 83: 738-744
- 27 Grönvall M, Tikkanen M, Tallberg E. et al. Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: a series of 50 cases from a tertiary teaching hospital. Acta Obstet Gynecol Scand 2013; 92: 433-438
- 28 Dueckelmann AM, Hinkson L, Nonnenmacher A. et al. Uterine packing with chitosan-covered gauze compared to balloon tamponade for managing postpartum hemorrhage. Eur J Obstet Gynecol Reprod Biol 2019; 240: 151-155