Parallel loop binding compression suture, a modified procedure for
pernicious placenta previa complicated with placenta increta: a
retrospective study. (with video)
Abstract
Abstract Objective. To evaluate the efficacy and safety of parallel loop
binding suture of the lower uterus during cesarean section in pernicious
placenta previa complicated with placenta increta. Design. A
retrospective study Setting. Qilu Hospital of Shandong University
Population. Patients with pernicious placenta previa between November
2014 and December 2020 at the Qilu Hospital of Shandong University were
eligible. Methods. The degree of placental invasion was evaluated using
preoperative color Doppler ultrasonography and/or magnetic resonance
imaging (MRI). Main outcome measures. Postpartum hemorrhage was
evaluated as the primary outcome. Additionally, neonatal outcomes were
evaluated. Results. Of the 38 patients, only 3 (7.89%) underwent
hysterectomy due to massive blood loss. With parallel loop binding
compression suture, the volume of blood lost ranged from 500 - 6000
(mean: 2152.63±1169.37) mL and the volume of blood transfused was
between 400 - 3200 (1431.58±699.85) mL. The mean gestational age was 36
weeks and 2 days (range: 32+6 to39+6 weeks). The average operation time
was 109.78 ± 33.49 min, and the average fetal childbirth time was
14.05±5.60 min. The rate of NICU admission was 36.84% (14/38). The
postoperative menstrual cycle and menstrual flow both returned to normal
levels. All infants at our hospital were safely discharged after
treatment. Conclusion. Parallel loop binding compression suture is an
effective, swift, practical, and safe method to reduce postpartum
bleeding in women with pernicious placenta previa, complicated with
placenta increta.