Abstract:

Objective:To evaluate the effect of double uterine incision combined with cervical lifting suture in the operation of placenta percreta.Methods: From January 2016 to December 2019, data from the patients diagnosed with placenta previa and percreta by prenatal ultrasonic and confirmed by intraoperative findings at the Gansu Provincial Maternity and Child Care Hospital were collected. 39 cases of patients with placenta percreta and placenta invasion in the cervix were treated with double uterine incision combined with cervical lifting suture. The general situation, intraoperative and postoperative conditions and perinatal outcomes of pregnant women were collected and analyzed retrospectively.Results: The median gestational weeks of 39 pregnant women were 35 weeks. The prognosis of all newborns was good. The intraoperative blood loss and blood transfusion volume was （2 083.33±927.60） mL and （1 190.38±718.68） mL, respectively. The operation time was （160.13±56.96） min. The median hospitalization days were 6 days. Bladder injury occurred in 4 patients when adhesion was separated. Transient coagulation dysfunction occurred in 4 patients. Fever occurred in 6 patients after operation. All patients were cured after symptomatic treatment. No hysterectomy or serious postoperative complications occurred. All patients recovered well and discharged smoothly.Conclusions: Double uterine incision combined with cervical lifting suture has significant hemostatic effect in the operation of pregnant women with placenta percreta and placenta invasion in the cervix orifice, which reduces the hysterectomy rate and is worthy of clinical application.

Key words: Hysterotomy, Placenta previa, Placenta accreta, Cesarean section, Suture techniques