Longitudinal parallel compression suture to control postopartum hemorrhage due to placenta previa and accrete

Abstract

Longitudinal parallel compression suture is a safe, easy, effective, practical, and conservative surgical technique to stop intractable PPH from the lower uterine segment, particularly in women who have a cesarean scar and placenta previa/accreta.

FIGO consensus guidelines on placenta accreta spectrum disorders: Conservative management,

“…Small case series have also reported the successful use of compression sutures, using the cervix as a natural tamponade by inverting it into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment . The latter technique of cervical inversion was successful in stopping bleeding in 38 out of 40 patients.…”

Ring compression suture for controlling post‐partum hemorrhage during cesarean section

“…Uterine compression sutures (UCS) are a recent innovation used to address PPH. A variety of UCS, including our series of reports, have achieved good hemostasis and preserved life and fertility. However, postoperative complications related to the remnant thread and persistent squeeze of UCS have been widely described in recent decades …”

“…The application of this suturing technique was approved by the Hospital Ethics Committees on November 15, 2012, and the approval number was MTK13017. The approval numbers and dates of the Ethics Committees for six previously published articles were MTK03006 on November 14, 2002 and MTK05010 on November 18, 2004, respectively. Two informed consent forms, for ordinary CS and for this procedure, were signed by the women and/or their nearest relatives before the operation.…”

“…In order to avoid possible adverse effects of our suturing techniques described previously, we devised a new ring compression suture (RCS), or removable uterus‐pubis binding suture (RUPBS), whose threads, that might induce potential adverse effects, are removed after 48 h postoperatively. The procedure is highly effective and can be used as an alternative to peripartum hysterectomy in every case of uncontrollable PPH and also has potential for prophylactic application in PPH.…”

Bilateral Uterine Artery Ligation and Square Sutures versus a Novel Combined Suture for Controlling Bleeding from the Placental Bed in Placenta Previa Centralis at Cesarean Section: A Randomized Clinical Trial

“…Fewer studies in the literature address the use of uterine compression sutures to stop bleeding from the placental bed in placenta previa (8,9).…”