Journal of International Obstetrics and Gynecology ›› 2011, Vol. 38 ›› Issue (5): 436-438.

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Clinical Research on Transverse Annular Compression Sutures in the Lower Uterine Segment to Control Postpartum Hemorrhage at Cesarean Delivery for Complete Placenta Previa

BAO Yi-rong,YING Hao,HUANG Yi-ying,ZHUANG Jing-yi,WANG De-fen   

  1. Department of Obstetrics,Shanghai First Maternity and Infant Hospital,Tongji University,School of Medicine,Shanghai 200040,China
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-10-15 Online:2011-10-15
  • Contact: YING Hao

Abstract: Objective:To evaluate the efficacy of transverse annular compression sutures(TACS)in the lower uterine segment in achieving homeostasis to control bleeding during cesarean delivery in women with complete placenta previa(CPP). Methods:Retrospectively analyze 60 cases who met the inclusion criteria with CPP during 2006,January to 2010,December. All the patients were divided into two groups:subsequent administration of either uterine packing(UP)or TACS. Blood loss,intervention time,and clinical efficacy were compared. Results:①There was no statistic difference between the UP group and the TACS group in gestational age at delivery,birth weight,the proportion of anterior placenta and the incidence of placenta accreta(P>0.05). ②No difference was found between the groups in oxytocin dose(P>0.05). However,carboprost usage amount was much more in the UP group(P<0.05). ③No difference was found between the groups in percentage of ante partum hemorrhage and the blood loss of antepartun. But there was greater blood loss in the UP group compared with the TACS group before the intervention,during the intervention,after the intervention,and throughout the cesarean delivery procedure(P<0.01). The percentage and quantity of blood transfused was also significantly higher in the UP group than in the TACS group(P<0.05 or P<0.01). ④The time taken to perform the uterine packing was significant longer than the time taken to perform TACS(P<0.05). The success rates were 91.7% and 97.2% for UP and TACS,respectively(P>0.05). ⑤Antibiotics using time and post-operative hospitalization time was significantly shorter in the TACS group than in the UP group(P<0.01). Conclusions:TACS appears to be a simple,effective and quick method in achieving homeostasis in women with CPP during cesarean delivery.

Key words: Placenta previa, Cesarean section, Postpartum hemorrhage, Suture techniques, Therapy