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CC BY 4.0 · AJP Rep 2025; 15(02): e79-e88
DOI: 10.1055/a-2608-0990
Original Article

Rectangular-Shaped Hemostatic Sutures in the Management of Second-Trimester Placenta Accreta Spectrum Disorders at Tu Du Hospital, Vietnam: A Retrospective Descriptive Study

Van Hoang Bui
1   Integrated Planning Room, Tu Du Hospital, Ho Chi Minh City, Vietnam
2   Clinical Research Center (CRC), Tu Du Hospital, Ho Chi Minh City, Vietnam
,
Hien Thi Nguyen
1   Integrated Planning Room, Tu Du Hospital, Ho Chi Minh City, Vietnam
,
Le Quyen Nguyen
1   Integrated Planning Room, Tu Du Hospital, Ho Chi Minh City, Vietnam
2   Clinical Research Center (CRC), Tu Du Hospital, Ho Chi Minh City, Vietnam
,
Phuong Thao Thi Truong
3   Department of Obstetrics and Gynecology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
,
Phuong Thao Nguyen
1   Integrated Planning Room, Tu Du Hospital, Ho Chi Minh City, Vietnam
,
Lam Phuong Thi Hoang
1   Integrated Planning Room, Tu Du Hospital, Ho Chi Minh City, Vietnam
,
Phuc Nhon Nguyen 
2   Clinical Research Center (CRC), Tu Du Hospital, Ho Chi Minh City, Vietnam
4   Department of Pregnancy Pathology, Tu Du Hospital, Ho Chi Minh City, Vietnam
› Author Affiliations
Funding None.
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Abstract

Objectives

The study aimed to delineate the surgical outcomes of rectangular-shaped sutures in PAS surgery.

Materials and Methods This retrospective study was conducted between January 2018 and December 2022 at Tu Du Hospital in Vietnam. The study reviewed all PAS cases below 22 weeks of gestational age (GA) that underwent cesarean delivery with rectangular-shaped hemostatic sutures. All the pregnancy characteristics, surgical features, and postoperative outcomes were described.

Results

Among thirteen pregnant women with PAS, GA from 13 to 17 weeks of GA occupied 11/13 cases. PAS was classified as accreta (n = 1), increta (n = 1), increta-percreta (n = 2), percreta (n = 4), and percreta invasive to other organs (n = 5). The estimated blood loss was 761.54 ± 614.12 (150–2,100 mL). Intraoperative blood loss between 500 and 1,500 mL accounted for 46.15%. The surgical duration time was 180.77 ± 32.07 (130–260 minutes). Postoperative duration time was 5.85 ± 2.08 (4–12 days). During the postpartum course, one case was reported with postpartum hemorrhage, acute renal dysfunction, and postoperative infection, respectively. Out of 13 PAS cases, 12 cases were successfully managed with conservative surgery.

Conclusion

Surgical management of PAS disorders using rectangular-shaped hemostatic sutures could be acceptable. The technical suture is simple, safe, and cost-effective.

Keywords

cesarean delivery - conservative surgery - complicated pregnancy - postpartum hemorrhage - placenta accreta spectrum - placenta previa - second trimester - ultrasound - Vietnam

Guarantor

The guarantors of this study are V.H.B. and P.N.N.


Ethical Approval

This study was accepted by the ethical committee of the institution with approval number CS/TD/23/15. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


Authors' Contributions

V.H.B. was responsible for conceptualization, methodology, investigation, administrative procedures, and supervision. H.N.T., L.Q.N., P.T.T.T., P.T.N., and L.P.H.T. were responsible for data collection, analysis, and administrative procedures. P.N.N. were responsible for methodology, analysis, and contributed to writing, reviewing, editing, and revising the manuscript. All authors read and approved the final manuscript.




Publication History

Received: 02 April 2025

Accepted: 05 May 2025

Accepted Manuscript online:
15 May 2025

Article published online:
10 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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