Archives of Gynecology and Obstetrics

, Volume 278, Issue 6, pp 555–557 | Cite as

Circular isthmic-cervical sutures can be an alternative method to control peripartum haemorrhage during caesarean section for placenta praevia accreta

Original Article
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Abstract

Objective

To study the control of peripartum bleeding in cases of caesarean section for placenta praevia accreta with the Circular isthmic-cervical sutures.

Method

Circular isthmic-cervical sutures were applied in six cases. To avoid ureter and bladder injury, the bladder was reflected downward. A silastic drain was inserted into internal and through the external os, so as to drain the uterine cavity and to keep the cervical canal open. Firstly, at the left side of the uterus, a Vicryl number two (No..2) stitch was inserted very close to the cervix from the anterior to the posterior side of the broad ligament. The stitch was then passed posteriorly to the right side of the uterus. The needle then was inserted again very close to the cervix from the posterior to the anterior wall of the broad ligament and was tightened on the anterior uterine surface, above the reflexion of the bladder as tightly as possible.

Result

Circular isthmic-cervical sutures were effective in all cases.

Conclusion

Circular isthmic-cervical suture is a quick, safe, simple and effective technique for controlling peripartum haemorrhage during caesarean section for placenta praevia accreta.

Keywords

Peripartum haemorrhage Placenta praevia Circular isthmic-cervical suture 
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References

  1. 1.
    Drife J (1997) Management of primary postpartum hemorrhage. Br J Obstet Gynecol 104:275–277Google Scholar
  2. 2.
    Read JA, Cotton DB, Miller FC (1980) Placenta accreta: changing clinical aspects and outcome. Obstet Gynecol 56:31–34PubMedGoogle Scholar
  3. 3.
    Cunningham FG, MacDonald PC, Gant NF, Leveno KJ, Gilstrap LC, Hankins GVD, Clark SL (1997) Obstetrical hemorrhage. In: Williams obstetrics, 20th edn, Chap. 32, Placental previa management. Appleton & Lange, Stamford, p 760Google Scholar
  4. 4.
    Griffiths D, Howell C (2003) Massive obstetric hemorrhage. In: Johanson R, Cox C, Gragy K, Howell C (eds) Managing obstetric emergencies and trauma, Chap. 16. RCOG Press, London, pp 150–162Google Scholar
  5. 5.
    O’ Leary JL, O’ Leary JA (1974) Uterine artery ligation for control of postcesarean section hemorrhage. Obstet Gynecol 43:849–853Google Scholar
  6. 6.
    Clark SL, Phelan JP, Yeh SY, Bruce SR, Paul RH (1985) Hypogastric artery ligation for obstetric hemorrhage. Obstet Gynecol 66:353–356PubMedGoogle Scholar
  7. 7.
    Burchell RC (1964) Internal iliac artery ligation: hemodynamics. Obstet Gynecol 24:737–738PubMedGoogle Scholar
  8. 8.
    Cho YJ (1991) Interrupted circular suture: bleeding control during cesarean delivery in placenta previa accreta. Obstet Gynecol 78(5):876–879PubMedGoogle Scholar
  9. 9.
    Hwu YM, Chen CP, Chen HS, Su TH (2005) Parallel vertical compression sutures: a technique to control bleeding from placenta preavia or accreta during caesarean section. BJOG October 112:1420–1423Google Scholar
  10. 10.
    Hayman RG, Arulkumaran S, Steer PJ (2002) Uterine compression sutures: surgical management of postpartum hemorrhage. Obstet Gynecol 99(3):502–506PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.“Iaso” Women’s HospitalMarousiGreece
  2. 2.Zurich UniversityZurichSwitzerland
  3. 3.AthensGreece

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