Parallel vertical compression sutures to control bleeding in cases of placenta previa and accreta.

OBJECTIVE: To evaluate the effectiveness of full-thickness vertical compression suture and intrauterine catheter in cases with placenta previa/accreta.

STUDY DESIGN: This study was conducted on Obstetrics and Gynecology emergency unit of Sohag University Hospital. Two longitudinal parallel full-thickness suture was taken using delayed absorbable suture (No. 2 Vicryl…) the entry of needle through anterior wall of lower uterine segment just above the internal os 2-3 cm medial to lateral aspect of lower uterine segment then completely piercing the posterior wall and then return from posterior wall to anterior wall 1-2 cm below incision line of the uterus. Another suture was taken in other side in the same manner. The Foley's catheter was inserted through the incision line into the cervix and balloon was inflated by 20-30 cc saline.

RESULTS: Two hundred and seventy-eight cases were included in the research. There were 107 cases without significant bleeding from lower uterine segment and no maneuver was needed. The remaining 171 cases were managed by vertical compression suture and intrauterine Foley's catheter which was successful in 168 cases (98.2%) to stop the bleeding. Only three cases cesarean total hysterectomy was needed.

CONCLUSIONS: Vertical lateral compression sutures with inserting inflated balloon of Foley's catheter is an effective method for controlling bleeding in cases of placenta previa/accreta.