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

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 100mL 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.