TITLE:
Clinical Analysis on the Effectiveness of Conservative Compression Suture Technique to Conserve Fertility on Pernicious Placenta Previa
AUTHORS:
Krishna Pyari Duguju, Jin He, Shuxin Li, Ashu Shrestha, Nasrat Rahim, Yanhong Shan
KEYWORDS:
Pernicious Placenta Previa, Conservative Compression Suture Techniques, Cesarean Section, Hysterectomy, Fertility
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.1,
January
15,
2019
ABSTRACT: Objective: To
evaluate the effectiveness of conservative compression surgical suture
techniques used for the management of pernicious placenta previa to
conserve fertility in the subsequent pregnancies. Study Design: This
was a non-comparative retrospective study of 188 patients diagnosed with pernicious
placenta previa who underwent cesarean section in The First Hospital of Jilin University,
China, from 1 January 2013 to 1 January 2018. Successful group was defined as those
in which the intraoperative bleeding was managed by either modified CHO or by
B-lynch suture technique and those who had further intervention including hysterectomy
were designated as failure group. Results: Out of
217 patients, 188 met inclusion criteria and 29 patients were excluded. In 188
cases, 183 (97.34%) cases successes and 5 (2.65%) cases had hysterectomy. Among
included group, 118 patients (62.76%) had undergone emergency cesarean section
and 70 patients (37.23%) underwent elective cesarean section. The emergency
group had significantly lesser gestation period of gestation at the time of
cesarean section (P = 0.021) and lower neonatal weight (P =
0.001) than that of elective group. The estimated blood loss during surgery was
500 - 3200 ml (mean: 925 ml). Additionally, the amount of bleeding was found to
be significantly more in patient with intraoperative complication (P = 0.007)
and in patient with implanted placenta (P 0.001). Conclusion: The conservative compression suture technique including modified CHO and
B-lynch suture technique during the cesarean delivery is a feasible, safe and
effective alternative conservative surgical technique for the management of
bleeding in case of pernicious placenta
previa. Besides good surgical outcome and proper neonatal result this
technique also reduces the rate of hysterectomy, thus conserving the fertility.