Cargando…
A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series
BACKGROUND: Pernicious placenta previa complicated by placenta accreta spectrum (PAS) often leads to hysterectomy or even maternal death due to massive bleeding. In recent years, the application of balloons has received increasing attention. It is easier to use and has reasonably good effect. Howeve...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350683/ https://www.ncbi.nlm.nih.gov/pubmed/34430581 http://dx.doi.org/10.21037/atm-21-2318 |
_version_ | 1783735821663207424 |
---|---|
author | Zhu, Lei Lu, Junli Huang, Wenyang Zhao, Jing Li, Menghui Zhuang, Huiyu Li, Yanfang Liu, Hao Du, Lingyun |
author_facet | Zhu, Lei Lu, Junli Huang, Wenyang Zhao, Jing Li, Menghui Zhuang, Huiyu Li, Yanfang Liu, Hao Du, Lingyun |
author_sort | Zhu, Lei |
collection | PubMed |
description | BACKGROUND: Pernicious placenta previa complicated by placenta accreta spectrum (PAS) often leads to hysterectomy or even maternal death due to massive bleeding. In recent years, the application of balloons has received increasing attention. It is easier to use and has reasonably good effect. However, for some patients, especially those who still have some placental residue, there might still be active bleeding. To solve this problem, we propose a method of pressure sutures around the balloon to provide a better hemostasis effect. METHODS: An observational study was conducted on patients with pernicious placenta previa and PAS at the Beijing Chaoyang Hospital, Beijing, China, between January 2018 and January 2021. During surgery, an intrauterine balloon was used to compress the hemorrhage site, and two or more absorbable sutures were placed around the uterus to apply strong pressure on the balloon. This method is an updated modification of the Lu-suture which uses a Foley catheter balloon and only one suture. The main improvements include choosing different kinds of balloons depending on various conditions and the addition of a suture below the balloon to provide much stronger pressure and prevent the balloon slipping out through the dilated cervix. RESULTS: A total of 10 women underwent the procedure. The mean estimated intraoperative blood loss was 1,190±548 mL. Post-surgery, the blood loss was less than 200 mL in all patients. The mean blood transfusion [packed red blood cells (pRBC)] required was 2.2±2.6 units. The mean hemostatic time was 8.1±3.4 minutes. CONCLUSIONS: The modified suture technique provided an easy, cheap, and efficient surgical choice for patients with pernicious placenta previa and PAS. |
format | Online Article Text |
id | pubmed-8350683 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-83506832021-08-23 A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series Zhu, Lei Lu, Junli Huang, Wenyang Zhao, Jing Li, Menghui Zhuang, Huiyu Li, Yanfang Liu, Hao Du, Lingyun Ann Transl Med Original Article BACKGROUND: Pernicious placenta previa complicated by placenta accreta spectrum (PAS) often leads to hysterectomy or even maternal death due to massive bleeding. In recent years, the application of balloons has received increasing attention. It is easier to use and has reasonably good effect. However, for some patients, especially those who still have some placental residue, there might still be active bleeding. To solve this problem, we propose a method of pressure sutures around the balloon to provide a better hemostasis effect. METHODS: An observational study was conducted on patients with pernicious placenta previa and PAS at the Beijing Chaoyang Hospital, Beijing, China, between January 2018 and January 2021. During surgery, an intrauterine balloon was used to compress the hemorrhage site, and two or more absorbable sutures were placed around the uterus to apply strong pressure on the balloon. This method is an updated modification of the Lu-suture which uses a Foley catheter balloon and only one suture. The main improvements include choosing different kinds of balloons depending on various conditions and the addition of a suture below the balloon to provide much stronger pressure and prevent the balloon slipping out through the dilated cervix. RESULTS: A total of 10 women underwent the procedure. The mean estimated intraoperative blood loss was 1,190±548 mL. Post-surgery, the blood loss was less than 200 mL in all patients. The mean blood transfusion [packed red blood cells (pRBC)] required was 2.2±2.6 units. The mean hemostatic time was 8.1±3.4 minutes. CONCLUSIONS: The modified suture technique provided an easy, cheap, and efficient surgical choice for patients with pernicious placenta previa and PAS. AME Publishing Company 2021-07 /pmc/articles/PMC8350683/ /pubmed/34430581 http://dx.doi.org/10.21037/atm-21-2318 Text en 2021 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Zhu, Lei Lu, Junli Huang, Wenyang Zhao, Jing Li, Menghui Zhuang, Huiyu Li, Yanfang Liu, Hao Du, Lingyun A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series |
title | A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series |
title_full | A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series |
title_fullStr | A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series |
title_full_unstemmed | A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series |
title_short | A modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series |
title_sort | modified suture technique for the treatment of patients with pernicious placenta previa and placenta accreta spectrum: a case series |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350683/ https://www.ncbi.nlm.nih.gov/pubmed/34430581 http://dx.doi.org/10.21037/atm-21-2318 |
work_keys_str_mv | AT zhulei amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT lujunli amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT huangwenyang amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT zhaojing amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT limenghui amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT zhuanghuiyu amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT liyanfang amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT liuhao amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT dulingyun amodifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT zhulei modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT lujunli modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT huangwenyang modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT zhaojing modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT limenghui modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT zhuanghuiyu modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT liyanfang modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT liuhao modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries AT dulingyun modifiedsuturetechniqueforthetreatmentofpatientswithperniciousplacentapreviaandplacentaaccretaspectrumacaseseries |