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June 1, 2026BMC Pregnancy and Childbirth0 citationsOpen Access

Suturing the placental bed in addition to intrauterine balloon tamponade, is it effective in placenta previa patients?

DEDuygu Tuğrul ErsakNONazlı OrhanGOGülcan Okutucu

Key Result

Suturing the placental bed in addition to intrauterine balloon tamponade was associated with a 3.2-fold increased risk of severe postpartum hemorrhage compared to balloon tamponade alone in placenta previa patients.

Key Points

  • This study aims to evaluate the effect of suturing the placental bed in patients with placenta previa on estimated blood loss during postpartum hemorrhage management.
  • Included 118 placenta previa patients applying intrauterine balloon tamponade for postpartum hemorrhage.
  • Divided into suture-negative group (65 patients) and suture-positive group (53 patients) based on suturing to the placental bed.
  • Measured estimated blood loss, clinicodemographic features, and other treatment parameters between both groups.
  • Suture-positive group exhibited higher estimated blood loss (p = 0.003).
  • Presence of suturing associated with severe postpartum hemorrhage (p = 0.017).
  • Median inflated volume of IUBT was 200 mL, with median duration of 12 hours in patients.

Study Design

Type

Cohort (n=118)

Multicenter

No

Structured PICO

Does suturing the placental bed in addition to intrauterine balloon tamponade reduce estimated blood loss in placenta previa patients with postpartum hemorrhage?

P
Population
118 placenta previa (PP) patients who were applied intrauterine balloon tamponade (IUBT) for postpartum hemorrhage (PPH)
I
Intervention
Suturing to the placental bed in addition to intrauterine balloon tamponade (IUBT) (n=53)
C
Comparator
Intrauterine balloon tamponade (IUBT) only (n=65)
O
Outcome
Estimated blood loss (EBL)surrogate

Administration of intrauterine balloon tamponade without suturing the placental bed may be sufficient to manage postpartum hemorrhage in low-risk placenta previa patients, as additional suturing was associated with higher estimated blood loss.

Main Result

Effect estimate: OR 3.2 (95% CI 1.2-8.5)

p-value: p=0.017

Limitations

  • Retrospective design
  • Suturing is typically performed in more severe cases, which may reflect underlying clinical complexity rather than a causal relationship (confounding by indication)
  • Single-center study

Abstract

BACKGROUND: This study aimed to examine the effectiveness of placental bed sutures in placenta previa (PP) patients and compare the amount of estimated blood loss (EBL) in patients who were only applied intrauterine balloon tamponade (IUBT) with the patients who were applied suturing to the placental bed in addition to IUBT. METHODS: PP patients (n:118) who were applied IUBT for postpartum hemorrhage (PPH) were the inclusion criteria. PP patients who were only applied IUBT constituted the suture-negative group (n:65) and the patients who were applied suturing to the placental bed in addition to IUBT constituted the suture-positive group (n:53). Clinicodemographic features, transfused blood and/or blood products, uterotonics used, EBL, and the volume IUBT inflated, and the duration of IUBT, were recorded and compared between the groups. RESULTS: The median volume IUBT inflated was 200 (160-460) mL and the median duration of IUBT was 12 (6-24) hours in PP patients. The amount of EBL was shown to be higher in suture-positive group (p = 0.003). Multivariate logistic regression analysis revealed that presence of suturing the placental bed was associated with severe PPH (p = 0.017). CONCLUSIONS: IUBT, is a successful method that is easily applicable, and administration of IUBT without suturing the placental bed may be sufficient to manage PPH in low-risk PP patients.

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Cite This Study

Ersak et al. (2026) conducted a cohort in Placenta previa with postpartum hemorrhage (n=118). Suturing the placental bed in addition to intrauterine balloon tamponade vs. Intrauterine balloon tamponade alone was evaluated on Severe postpartum hemorrhage (Estimated blood loss ≥1000 mL) (OR 3.2, 95% CI 1.2-8.5, p=0.017). Suturing the placental bed in addition to intrauterine balloon tamponade was associated with a 3.2-fold increased risk of severe postpartum hemorrhage compared to balloon tamponade alone in placenta previa patients.

synapsesocial.com/papers/6a1d216202fbce913063774ahttps://doi.org/10.1186/s12884-026-09366-w
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Also Consider

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  1. 1Innovative hemostasis technique for cesarean section in placenta previa: A retrospective study2024 · 2 citations
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