Parallel Loop Binding Compression Suture, a Modified Procedure for Pernicious Placenta Previa Complicated With Placenta Increta

Mengdi Fu; Hualei Bu; Yan Fang; Chunling Wang; Li Zhang; Yang Zhang; Xiao Sun; Mingbao Li; Chengjuan Jin; Yintao Xu; Lijun Chen

doi:10.3389/fsurg.2021.786497

Parallel Loop Binding Compression Suture, a Modified Procedure for Pernicious Placenta Previa Complicated With Placenta Increta

Front Surg. 2021 Nov 29:8:786497. doi: 10.3389/fsurg.2021.786497. eCollection 2021.

Authors

Mengdi Fu¹, Hualei Bu¹, Yan Fang¹, Chunling Wang², Li Zhang², Yang Zhang³, Xiao Sun⁴, Mingbao Li¹, Chengjuan Jin⁵, Yintao Xu¹, Lijun Chen¹

Affiliations

¹ Department of Gynecology and Obstetrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
² Department of Anesthesia, Qilu Hospital, Shandong University, Jinan, China.
³ Department of Radiology, Qilu Hospital, Shandong University, Jinan, China.
⁴ Department of Ultrasound, Qilu Hospital, Shandong University, Jinan, China.
⁵ Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Objective: To evaluate the efficacy and safety of parallel loop binding compression suture of the lower uterus during cesarean section in pernicious placenta previa complicated with placenta increta. Methods: This retrospective study was performed in patients with pernicious placenta previa complicated with placenta increta or percreta between November 2014 and December 2020 at the Qilu Hospital of Shandong University. Patients underwent parallel loop binding compression suture surgery were defined as study group, and patients underwent traditional surgery with figure-of-eight sutures as the main hemostatic method were defined as control group. Postpartum hemorrhage was evaluated as the primary outcome. The secondary outcomes included age, gestational weeks, operative time, fetal childbirth time, prevention of hysterectomy, blood transfusion, duration of postoperative catheterization, duration of antibiotic treatment, and postoperative hospitalization (days). Additionally, neonatal outcomes were evaluated. Results: A total of 124 patients were enrolled in the study, including 38 patients receiving parallel loop binding compression suture surgery in the study group, and 86 patients in the control group. With parallel loop binding compression suture, the average operation time was significantly reduced (109.0 ± 33.5 vs. 134.4 ± 54.2 min, p = 0.00), and the volume of blood lost were also decreased (2152.6 ± 1169.4 vs. 2960.5 ± 1963.6 ml, p = 0.02), which correspondingly reduced RBC transfusion (7.2 ± 3.5 vs. 10.3 ± 8.7 units, p = 0.03) and FFP transfusion (552.6 ± 350.3 vs. 968.0 ± 799.8 ml, p = 0.00). The fetal childbirth time was extended (14.1 ± 5.6 vs. 11.0 ± 8.0 min, p = 0.03), however, there was no increase in NICU admission rates (36.9 vs. 34.9%, p = 0.83). Except for one premature infant (32 weeks) death in the control group, 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. Besides, it has no adverse effects on newborns.

Keywords: cesarean section; newborns; parallel loop binding compression suture; pernicious placenta previa; placenta increta.