Skip to main content
SpringerLink
Log in

The efficacy between cervical-lifting suture and lower B-Lynch suture in placenta previa: a retrospective cohort-study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

This study is performed to evaluate and compare the efficacy of cervical-lifting suture and lower B-Lynch suture in different severity of placenta previa associated with lower uterine segment bleeding.

Methods

We evaluated the effectiveness of cervical-lifting suture (n = 51) and lower B-Lynch suture (n = 137) in stopping the bleeding from lower uterine segment. Additionally, we used different statistical methods, including overall analysis, subgroup analysis and approximate randomization analysis, to evaluate the efficacy of the two assessments.

Results

The medical records of these 188 participants were extracted and all of the patients were followed up for six weeks. The majority of patients were multipara and complicated with previous cesarean delivery and abnormal adherent placenta. The median intraoperative blood loss and the median amount of red blood cell transfusion were lower in the cervical-lifting suture group in comparison to the lower B-Lynch suture group.

Conclusion

Our study provides evidence that cervical-lifting suture has less intraoperative blood loss and red blood cell transfusion for controlling lower uterine segment bleeding in placenta previa.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Solheim KN, Esakoff TF, Little SE, Cheng YW, Sparks TN, Caughey AB (2011) The effect of cesarean delivery rates on the future incidence of placenta previa, placenta accreta, and maternal mortality. J Maternal-fetal Neonatal 24(11):1341–1346. https://doi.org/10.3109/14767058.2011.553695

    Article  Google Scholar 

  2. Li HT, Luo S, Trasande L, Hellerstein S, Kang C, Li JX, Zhang Y, Liu JM, Blustein J (2017) Geographic variations and temporal trends in cesarean delivery rates in China, 2008–2014. JAMA 317(1):69–76. https://doi.org/10.1001/jama.2016.18663

    Article  PubMed  Google Scholar 

  3. Betran AP, Ye J, Moller AB, Zhang J, Gulmezoglu AM, Torloni MR (2016) The increasing trend in caesarean section rates: global, regional and national estimates: 1990–2014. PLoS ONE 11(2):e0148343. https://doi.org/10.1371/journal.pone.0148343

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Luke RK, Sharpe JW, Greene RR (1966) Placenta accreta: the adherent or invasive placenta. Am J Obstet Gynecol 95(5):660–668. https://doi.org/10.1016/s0002-9378(16)34741-x

    Article  CAS  PubMed  Google Scholar 

  5. Mullen C, Battarbee AN, Ernst LM, Peaceman AM (2019) Occult placenta accreta: risk factors, adverse obstetrical outcomes, and recurrence in subsequent pregnancies. Am J Perinatol 36(5):472–475. https://doi.org/10.1055/s-0038-1669440

    Article  PubMed  Google Scholar 

  6. Jauniaux E, Alfirevic Z, Bhide AG, Belfort MA, Burton GJ, Collins SL, Dornan S, Jurkovic D, Kayem G, Kingdom J, Silver R, Sentilhes L (2019) Placenta praevia and placenta accreta: diagnosis and management: green-top guideline No. 27a. BJOG 126(1):e1–e48. https://doi.org/10.1111/1471-0528.15306

    Article  PubMed  Google Scholar 

  7. Allen L, Jauniaux E, Hobson S, Papillon-Smith J, Belfort MA (2018) FIGO consensus guidelines on placenta accreta spectrum disorders: nonconservative surgical management. Int J Gynaecol Obst 140(3):281–290. https://doi.org/10.1002/ijgo.12409

    Article  Google Scholar 

  8. Li GT, Li XF, Wu B, Li G (2016) Longitudinal parallel compression suture to control postopartum hemorrhage due to placenta previa and accrete. Taiwan J Obstet Gynecol 55(2):193–197. https://doi.org/10.1016/j.tjog.2016.02.008

    Article  PubMed  Google Scholar 

  9. Meng Y, Wu P, Deng D, Wu J, Lin X, Beejadhursing R, Zha Y, Qiao F, Feng L, Liu H, Zeng W (2017) Multifaceted spiral suture: a hemostatic technique in managing placenta praevia or accrete: a retrospective study. Medicine 96(49):e9101. https://doi.org/10.1097/md.0000000000009101

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mohamed MA (2017) Parallel vertical compression sutures to control bleeding in cases of placenta previa and accreta. J Maternal-fetal Neonatal Med. https://doi.org/10.1080/14767058.2017.1387895

    Article  Google Scholar 

  11. Acar A, Ercan F, Pekin A, Elci Atilgan A, Sayal HB, Balci O, Gorkemli H (2018) Conservative management of placental invasion anomalies with an intracavitary suture technique. Int J Gynaecol Obstet 143(2):184–190. https://doi.org/10.1002/ijgo.12593

    Article  CAS  PubMed  Google Scholar 

  12. Chen YS, Zhao YY, Zhang Y, Wang Y, Zhong YW, Zhang AQ (2018) Application of cervical lifting suture in hemostasis of placenta previa with increta and percreta. Zhonghua fu chan ke za zhi 53(7):459–463. https://doi.org/10.3760/cma.j.issn.0529-567x.2018.07.004

    Article  CAS  PubMed  Google Scholar 

  13. Shih JC, Liu KL, Kang J, Yang JH, Lin MW, Yu CU (2018) 'Nausicaa' compression suture: a simple and effective alternative to hysterectomy in placenta accreta spectrum and other causes of severe postpartum haemorrhage. BJOG. https://doi.org/10.1111/1471-0528.15410

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bl C, Coker A, Lawal AH, Abu J, Cowen MJ (1997) The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol 104(3):372–375

    Article  Google Scholar 

  15. Dedes I, Ziogas V (2008) Circular isthmic-cervical sutures can be an alternative method to control peripartum haemorrhage during caesarean section for placenta praevia accreta. Arch Gynecol Obstet 278(6):555–557. https://doi.org/10.1007/s00404-008-0646-z

    Article  PubMed  Google Scholar 

  16. Li GT, Li GR, Li XF, Wu BP (2016) Funnel compression suture: a conservative procedure to control postpartum bleeding from the lower uterine segment. BJOG 123(8):1380–1385. https://doi.org/10.1111/1471-0528.13685

    Article  CAS  PubMed  Google Scholar 

  17. Cho JH, Jun HS, Lee CN (2000) Hemostatic suturing technique for uterine bleeding during cesarean delivery. Obstet Gynecol 96(1):129–131

    CAS  PubMed  Google Scholar 

  18. Hayman RG, Arulkumaran S, Steer PJ (2002) Uterine compression sutures: surgical management of postpartum hemorrhage. Obstet Gynecol 99(3):502–506

    CAS  PubMed  Google Scholar 

  19. Palacios-Jaraquemada JM (2011) Efficacy of surgical techniques to control obstetric hemorrhage: analysis of 539 cases. Acta Obstet Gynecol Scand 90(9):1036–1042. https://doi.org/10.1111/j.1600-0412.2011.01176.x

    Article  PubMed  Google Scholar 

  20. Chandraharan E, Rao S, Belli AM, Arulkumaran S (2012) The Triple-P procedure as a conservative surgical alternative to peripartum hysterectomy for placenta percreta. Int J Gynaecol Obstetrics 117(2):191–194. https://doi.org/10.1016/j.ijgo.2011.12.005

    Article  Google Scholar 

  21. Shazly SA, Badee AY, Ali MK (2012) The use of multiple 8 compression suturing as a novel procedure to preserve fertility in patients with placenta accreta: case series. Aust N Z J Obstet Gynaecol 52(4):395–399. https://doi.org/10.1111/j.1479-828X.2012.01449.x

    Article  Google Scholar 

  22. Ratiu AC, Crisan DC (2018) A prospective evaluation and management of different types of placenta praevia using parallel vertical compression suture to preserve uterus. Medicine 97(46):e13253. https://doi.org/10.1097/md.0000000000013253

    Article  PubMed  PubMed Central  Google Scholar 

  23. Jauniaux E, Bhide A (2017) Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: a systematic review and meta-analysis. Am J Obstet Gynecol 217(1):27–36. https://doi.org/10.1016/j.ajog.2017.02.050

    Article  PubMed  Google Scholar 

  24. Lodhi W, Golara M, Karangaokar V, Yoong W (2012) Uterine necrosis following application of combined uterine compression suture with intrauterine balloon tamponade. J Obstet Gynaecol 32(1):30–31. https://doi.org/10.3109/01443615.2011.614972

    Article  CAS  PubMed  Google Scholar 

  25. Ploteau S, Renou M, Lopes P (2012) Uterine necrosis and pyometra following surgical hemostatic Cho suture for postpartum haemorrhage: two cases. Eur J Obstet Gynecol Reprod Biol 161(2):233–234. https://doi.org/10.1016/j.ejogrb.2011.12.015

    Article  PubMed  Google Scholar 

  26. Rashmi MD, Lokeshchandra HC, Chaitra TM (2013) Uteroumbilical fistula with myometrial necrosis following compression suture for atonic PPH: a rare case. Arch Gynecol Obstet 287(5):1045–1046. https://doi.org/10.1007/s00404-012-2606-x

    Article  CAS  PubMed  Google Scholar 

  27. Simpson AN, Pittini R, Hui D, Morgan A, Kroft J (2015) Uterine full thickness multifocal dehiscence associated with a history of cho uterine compression sutures. JOGC 37(7):583. https://doi.org/10.1016/s1701-2163(15)30192-4

    Article  PubMed  Google Scholar 

  28. Benkirane S, Saadi H, Serji B, Mimouni A (2017) Uterine necrosis following a combination of uterine compression sutures and vascular ligation during a postpartum hemorrhage: a case report. Int J Surg Case Rep 38:5–7. https://doi.org/10.1016/j.ijscr.2017.07.005

    Article  PubMed  PubMed Central  Google Scholar 

  29. Chikazawa K, Imai K, Liangcheng W, Sasaki S, Horiuchi I, Kuwata T, Takagi K (2018) Detection of Asherman's syndrome after conservative management of placenta accreta: a case report. J Med Case Rep 12(1):344. https://doi.org/10.1186/s13256-018-1869-7

    Article  PubMed  PubMed Central  Google Scholar 

  30. Mallappa Saroja CS, Nankani A, El-Hamamy E (2010) Uterine compression sutures, an update: review of efficacy, safety and complications of B-Lynch suture and other uterine compression techniques for postpartum haemorrhage. Arch Gynecol Obstet 281(4):581–588. https://doi.org/10.1007/s00404-009-1249-z

    Article  PubMed  Google Scholar 

  31. Matsubara S, Yano H, Ohkuchi A, Kuwata T, Usui R, Suzuki M (2013) Uterine compression sutures for postpartum hemorrhage: an overview. Acta Obstet Gynecol Scand 92(4):378–385. https://doi.org/10.1111/aogs.12077

    Article  PubMed  Google Scholar 

  32. Mohamed MA, Mohammed AH (2019) Parallel vertical compression sutures to control bleeding in cases of placenta previa and accreta. J Maternal-fetal Neonatal Med 32(4):641–645. https://doi.org/10.1080/14767058.2017.1387895

    Article  Google Scholar 

  33. Vijayasree M (2016) Efficacy of prophylactic B-Lynch suture during lower segment caesarian section in high risk patients for atonic postpartum haemorrhage. KUMJ 14(53):9–12

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank the academic support of Science and Technology of North Sichuan Medical College.

Funding

No funding source was involved.

Author information

Author notes

  1. Yanqiong Gan and Zhaoxia Chen are Joint first authors.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The Affiliated Hospital of North Sichuan Medical College, No.63, Wenhua Road, Shunqing District, Nanchong, 637000, Sichuan, People’s Republic of China

    Yanqiong Gan, Zhaoxia Chen & Qi Shi

Authors
  1. Yanqiong Gan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhaoxia Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qi Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

YG: data analysis and manuscript writing; ZC: data collection; QS: project development.

Corresponding author

Correspondence to Qi Shi.

Ethics declarations

Conflict of interest

None declared.

Informed consent

The informed consent is not applicable. But the study protocol had been approved by the Ethics Committee of Science and Technology of North Sichuan Medical College.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gan, Y., Chen, Z. & Shi, Q. The efficacy between cervical-lifting suture and lower B-Lynch suture in placenta previa: a retrospective cohort-study. Arch Gynecol Obstet 302, 365–376 (2020). https://doi.org/10.1007/s00404-020-05625-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05625-z

Keywords

Search

Navigation